Table of Contents
ISRN Obstetrics and Gynecology
Volume 2013 (2013), Article ID 297921, 17 pages
http://dx.doi.org/10.1155/2013/297921
Clinical Study

Definition of Compartment Based Radical Surgery in Uterine Cancer—Part I: Therapeutic Pelvic and Periaortic Lymphadenectomy by Michael Höckel Translated to Robotic Surgery

Department Gynecology and Obstetrics University Clinic Essen, West German Cancer Center, University Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany

Received 20 December 2012; Accepted 19 January 2013

Academic Editors: N. A. Ginsberg and J. G. Schenker

Copyright © 2013 Rainer Kimmig et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To define compartment based therapeutic pelvic and periaortic lymphadenectomy in cervical and endometrial cancer. Compartment based oncologic surgery appears to be favorable for patients in terms of radicality as well as complication rates, and the same appears to be true for robotic surgery. We describe a method of robotically assisted compartment based lymphadenectomy step by step in uterine cancer and demonstrate feasibility data from 35 patients. Methods. Patients with the diagnosis of endometrial or cervical cancer were included. Patients were treated by rTMMR (robotic total mesometrial resection) or rPMMR (robotic peritoneal mesometrial resection) and pelvic or pelvic/periaortic rtLNE (robotic therapeutic lymphadenectomy) with cervical cancer FIGO IB-IIA or endometrial cancer FIGO I-III. Results. No transition to open surgery was necessary. Complication rates were 13% for endometrial cancer and 21% for cervical cancer. Within follow-up time median (22/20) month we noted 1 recurrence of cervical cancer and 2 endometrial cancer recurrences. Conclusions. We conclude that compartment based rtLNE is a feasible and safe technique for the treatment of uterine cancers and is favorable in aspects of radicality and complication rates. It should be analyzed in multicenter studies with extended followup on the basis of the described technique.