Pretreatment transperitoneal laparoscopic staging pelvic and paraaortic lymphadenectomy in large (> or = 5 cm) stage IB2 cervical carcinoma: report of a pilot study.

Twelve patients with large stage IB2 (5-8 cm) cervical carcinoma underwent transperitoneal laparoscopically directed pelvic and paraaortic lymph node dissection prior to the initiation of radiation therapy. The mean length of operation was 176 min and the mean estimated blood loss was 60 cc. An average of 25 lymph nodes were retrieved from each patient: 18 pelvic lymph nodes and 7 paraaortic lymph nodes. No patients were hospitalized for more than 24 hr. No operative complications were observed. Pelvic nodal metastases were diagnosed in three patients, all of whom had negative computerized tomography (CT) scans prior to surgery. All patients began radiation therapy within 1 week of surgery. Laparoscopically directed lymphadenectomy for patients with stage IB2 cervical carcinoma is technically feasible, is associated with minimal morbidity, short hospital stay, and minimal delay prior to radiation therapy, and can add valuable information to radiation treatment planning.