Abstract:
Objectives: Para-aortic lymph nodes dissection in patients with ovarian cancer is very important in diagnosis and prognosis. Transmesentric and retrocaecal approaches are commonly used to remove malignant para-aortic lymph nodes.
Patients and Methods: This study is a retrospective randomized controlled study and included 100 cases with operable ovarian cancer with pathologically enlarged para-aortic lymph nodes. These patients were subdivided into two groups; 1st group included 50 cases subjected to direct trans mesenteric para-aortic lymph nodes dissection, and the other group included 50 cases subjected to the retro- Caecal (retroperitoneal) approach to dissect para- aortic lymph nodes. Comparison between the two groups regarding operative time, blood loss, complications and number of lymph nodes dissected was done.
Results: In this study there were no statistically significantly differences among patients in both groups regarding age, parity, stage, histopathological subtype. The mean number of harvested lymph nodes in the 1st group was 3.6±1.36 lymph nodes, while in the 2nd group it was 2.9±1.36 lymph nodes. Operative time was statistically different in both groups. Also, the amount of blood loss was statistically significantly different in both groups. Complications related to lower para-aortic lymph nodes dissection were present in the 2nd group only; 2 cases with ureteric injury (partial cut) were reported.
Conclusion: Transmesentric approach for para aortic lymph nodes dissection in patient with ovarian cancer is better than the retrocaecal approach it is associated with shorter operation time, less blood loss, more harvested lymph nodes and less complications. But both approaches could be used safely.
