2019 Volume 35 Issue 1 Pages 75-79
Objective: This study verified the feasibility of the laparoscopic approach for sentinel lymph node (SLN) surgery in cervical cancer.
Design: We retrospectively reviewed data for 154 patients with cervical cancer who had undergone SLN mapping, with technetium colloid (Tc99m) and/or indocyanine green (ICG) injected into the uterine cervix and an intraoperative gamma-detecting probe and/or photodynamic eye camera system used to locate hot spots. We compared the SLN detection rate (unilateral or bilateral) and incidence of complications between open approach (O group n=108) and laparoscopic approach (L group, n=46).
Results: Patients' median age was 43 years; 143 (93%) had FIGO Stage I disease. Successful bilateral and unilateral mapping occurred in 117 (76%) and 26 (17%) patients, respectively. The two groups did not significantly differ in median patient age, BMI, histology, tumor diameter or use of the two kinds of tracers. Median number of harvested lymph nodes was significantly lower in the L group (40 vs. 25, P＝0.0003). The two groups did not significantly differ in SLN detection rates (P=0.98). The perioperative complication rate tended to be lower in the L group (21% vs. 11%, P=0.12). However, the laparoscopic approach was not confirmed as an independent risk factor for perioperative complication in our logistic regression analysis.
Conclusion: SLN detection by the laparoscopic approach could equal that of the open approach without increasing perioperative complications. However, its long-term effect on oncologic prognosis was not assessed due to the relatively short follow-up period in the present study.
