PELVIC LYMPH NODE CLEARANCE
pelvic node clearance is done as part of radical surgery for gynaecological cancers or as an isolated procedure to stage cancers. this can be done laparoscopically or as an open surgery. when it is done by an experinced gyae oncologist this surgery carries minimal risk. when it is done laparoscopically the recovery is faster and you can return to normal life at the earliest
types of cancers where node clearance is done
- Cancer of cervix
- Cancer of uterus
- Cancer of vagina
Lymph node removal is performed with the following aims:
- Staging: to document the extent of disease spread accurately, thus permitting comparative evaluations.
- Therapeutics: to treat in accordance with retrospective investigations that have suggested a therapeutic role for pelvic and para-aortic lymph node removal.
- Diagnostics: to determine the need for and extent of postoperative treatment.
Complications of Pelvic Lymphadenectomy
- lymphocoele
- thromboembolism
- ureteral injury
- nerve injury
- vascular injury
A hysterectomy is most effective for cancer treatment if the exploration during surgery shows the cancer has not spread beyond the uterus. Some patients, however, will have cancer that has spread outside the uterus into the lymph nodes in the pelvis. Before the hysterectomy is done, the doctor will sometimes perform a pelvic lymph node dissection. During a pelvic lymph node dissection, the surgeon removes lymph nodes to determine whether they contain cancer. If the lymph nodes contain cancer, the surgeon may not proceed with the hysterectomy. Another form of treatment, usually radiation therapy and chemotherapy, is generally recommended.
A hysterectomy is most effective for cancer treatment if the exploration during surgery shows the cancer has not spread beyond the uterus. Some patients, however, will have cancer that has spread outside the uterus into the lymph nodes in the pelvis. Before the hysterectomy is done, the doctor will sometimes perform a pelvic lymph node dissection. During a pelvic lymph node dissection, the surgeon removes lymph nodes to determine whether they contain cancer. If the lymph nodes contain cancer, the surgeon may not proceed with the hysterectomy. Another form of treatment, usually radiation therapy and chemotherapy, is generally recommended.
Main Points
Pelvic lymph node dissection (PLND) is the gold standard for the detection of hidden node cancer cells from pelvic cancers.
Important advantages of PLND are accurate staging and patient peace of mind.
May also be a therapeutic benefit associated with PLND
Common complications are lymphocele formation, thromboembolic events, vascular injury, nerve injury, and ureteral injury