LymphedemaV1, Main, Exploration, bibRecord, 000B51

Robotic-assisted Trans-peritoneal Pelvic Lymphadenectomy For Metastatic Melanoma: Early Outcomes Compared To Open Pelvic Lymphadenectomy

Identifieur interne : 000B51 ( Main/Exploration ); précédent : 000B50; suivant : 000B52

Robotic-assisted Trans-peritoneal Pelvic Lymphadenectomy For Metastatic Melanoma: Early Outcomes Compared To Open Pelvic Lymphadenectomy

Auteurs : Lesly A. Dossett [États-Unis] ; Nicholas B. Castner [États-Unis] ; Julio M. Pow-Sang ; Andrea M. Abbott [États-Unis] ; Vernon K. Sondak [États-Unis] ; Amod A. Sarnaik [États-Unis] ; Jonathan S. Zager [États-Unis]

Source :

Journal of the American College of Surgeons [ 1072-7515 ] ; 2016.

RBID : PMC:4871144

Abstract

Background

In the absence of iliac or obturator nodal involvement, the role of pelvic lymphadenectomy (PLND) for melanoma is controversial, but for select patients long-term survival may be achieved with the combination of superficial inguinal (inguinofemoral) and pelvic lymphadenectomy. Open PLND (oPLND) is often limited in visual exposure and may be associated with significant postoperative pain. Robotic PLND (rPLND) is a minimally invasive technique that provides excellent visualization of the iliac and obturator nodes. Outcomes comparing the open and robotic techniques for have not been previously reported for patients with melanoma.

Study Design

We reviewed our experience with rPLND for melanoma and compared clinical and pathologic results to oPLND. We evaluated operative times, nodal yield and short-term oncologic outcomes.

Results

13 rPLND (2013–2015) (15 attempted, 87% success rate) and 25 oPLND (2010–2015) consecutive cases were completed. PLND was combined with an open inguinofemoral dissection in 8 of 13 (62%) robotic and 17 of 25 (68%) open cases. Median length of stay (LOS) was shorter in the rPLND group with 1.0 versus 3.5 days for pelvic only cases (p<0.001) and 2.5 versus 4.0 days (p<0.001) for combined ilioinguinal cases. Median operative time (227 versus 230 minutes, p=0.96) and nodal yield (11 versus 10 nodes, p=0.53) were not different between rPLND and oPLND.

Conclusions

rPLND offers a safe, effective minimally invasive approach to resect the pelvic lymph nodes in patients with melanoma, with no significant difference in nodal yield or operative times, but a shorter LOS compared to oPLND.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871144

DOI: 10.1016/j.jamcollsurg.2015.12.033
PubMed: 26875071
PubMed Central: 4871144

Affiliations:

Le document en format XML

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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">In the absence of iliac or obturator nodal involvement, the role of pelvic lymphadenectomy (PLND) for melanoma is controversial, but for select patients long-term survival may be achieved with the combination of superficial inguinal (inguinofemoral) and pelvic lymphadenectomy. Open PLND (oPLND) is often limited in visual exposure and may be associated with significant postoperative pain. Robotic PLND (rPLND) is a minimally invasive technique that provides excellent visualization of the iliac and obturator nodes. Outcomes comparing the open and robotic techniques for have not been previously reported for patients with melanoma.</p>
</sec>
<sec id="S2"><title>Study Design</title>
<p id="P2">We reviewed our experience with rPLND for melanoma and compared clinical and pathologic results to oPLND. We evaluated operative times, nodal yield and short-term oncologic outcomes.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">13 rPLND (2013–2015) (15 attempted, 87% success rate) and 25 oPLND (2010–2015) consecutive cases were completed. PLND was combined with an open inguinofemoral dissection in 8 of 13 (62%) robotic and 17 of 25 (68%) open cases. Median length of stay (LOS) was shorter in the rPLND group with 1.0 versus 3.5 days for pelvic only cases (p<0.001) and 2.5 versus 4.0 days (p<0.001) for combined ilioinguinal cases. Median operative time (227 versus 230 minutes, p=0.96) and nodal yield (11 versus 10 nodes, p=0.53) were not different between rPLND and oPLND.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">rPLND offers a safe, effective minimally invasive approach to resect the pelvic lymph nodes in patients with melanoma, with no significant difference in nodal yield or operative times, but a shorter LOS compared to oPLND.</p>
</sec>
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Robotic-assisted Trans-peritoneal Pelvic Lymphadenectomy For Metastatic Melanoma: Early Outcomes Compared To Open Pelvic Lymphadenectomy

Robotic-assisted Trans-peritoneal Pelvic Lymphadenectomy For Metastatic Melanoma: Early Outcomes Compared To Open Pelvic Lymphadenectomy

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