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Extraperitoneal lymph node dissections with use of a midline incision in patients with female genital cancer

  • Donald G. Gallup
    Correspondence
    Reprint requests: Donald G. Gallup, M.D., Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta, GA 30912.
    Affiliations
    Department of Obstetrics and Gynecology, Naval Hospital Augusta, Georgia USA.

    Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta, Georgia USA.
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  • Gerald H. Jordan
    Affiliations
    Department of Obstetrics and Gynecology, Naval Hospital Augusta, Georgia USA.

    Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta, Georgia USA.
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  • O.Eduardo Talledo
    Affiliations
    Department of Obstetrics and Gynecology, Naval Hospital Augusta, Georgia USA.

    Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta, Georgia USA.
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      Abstract

      Recent investigations have suggested that extraperitoneal, as compared to transperitoneal, lymph node dissections may result in significantly less morbidity in patients who later have external beam irradiation. Some incisions designed to perform such dissections do not afford easy access to the opposite side. With use of a midline incision carried down to the preperitoneal space, 30 patients underwent bilateral pelvic lymph node dissections. When necessary, access to the para-aortic nodes by an extraperitoneal approach was accomplished by use of a modification of this midline incision. Operating time to complete the pelvic dissection ranged from 35 to 90 minutes. The mean estimated blood loss for the dissection was 135 ml. The advantages of this extraperitoneal approach include easy access to lymph nodes on either side, ability to use the peritoneum as a pack, and an easier access to the obturator space nodes.

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