Pelvic adhesion formation after pelvic lymphadenectomy: Comparison between transperitoneal laparoscopy and extraperitoneal laparotomy in a porcine model

J. M. Fowler, E. M. Hartenbach, H. T. Reynolds, J. Borner, J. R. Carter, J. W. Carlson, L. B. Twiggs, L. F. Carson

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Compared to extraperitoneal laparotomy, the transperitoneal approach is associated with increased enteric morbidity. Recently, transperitoneal laparoscopy has been employed as a method to surgically stage patients with gynecologic malignancies. The objective of this study was to investigate pelvic adhesion formation in a porcine model after pelvic lymphadenectomy performed via transperitoneal laparoscopy (LS) compared to extraperitoneal laparotomy (EP). Ten adult, female hogs underwent LS and 10 underwent EP. A complete pelvic lymphadenectomy was performed in each animal. Three weeks after the lymphadenectomy, the animals underwent exploratory laparotomy, and the adhesions were quantified. Nineteen animals were evaluable. The adhesion scores for the laparoscopy group (N = 10, mean = 0.075 ± 0.17) were not statistically different from those of the laparotomy group (N = 9, mean = 0.28 ± 0.52, P > 0.5). Eight of 10 (80%) and 5 of 9 (56%) animals in the LS and EP groups, respectively, had no adhesions after pelvic lymphadenectomy. Adhesion formation is one of many critical issues concerning the utility of pretreatment surgical staging, especially for cancer of the cervix. It is remarkable that only 20% of the animals undergoing laparoscopy in this study had de novo adhesions after pelvic lymph node dissection and that the mean total adhesion score was not statistically different from the extraperitoneal laparotomy. Therefore, transperitoneal laparoscopic pelvic lymphadenectomy may not induce the degree of adhesion formation associated with the transperitoneal laparotomy technique.

Original languageEnglish
Pages (from-to)25-28
Number of pages4
JournalGynecologic Oncology
Volume55
Issue number1
DOIs
StatePublished - Nov 4 1994
Externally publishedYes

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Lymph Node Excision
Laparoscopy
Laparotomy
Swine
Uterine Cervical Neoplasms
Morbidity
Neoplasms

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Pelvic adhesion formation after pelvic lymphadenectomy : Comparison between transperitoneal laparoscopy and extraperitoneal laparotomy in a porcine model. / Fowler, J. M.; Hartenbach, E. M.; Reynolds, H. T.; Borner, J.; Carter, J. R.; Carlson, J. W.; Twiggs, L. B.; Carson, L. F.

In: Gynecologic Oncology, Vol. 55, No. 1, 04.11.1994, p. 25-28.

Research output: Contribution to journalArticle

Fowler, JM, Hartenbach, EM, Reynolds, HT, Borner, J, Carter, JR, Carlson, JW, Twiggs, LB & Carson, LF 1994, 'Pelvic adhesion formation after pelvic lymphadenectomy: Comparison between transperitoneal laparoscopy and extraperitoneal laparotomy in a porcine model', Gynecologic Oncology, vol. 55, no. 1, pp. 25-28. https://doi.org/10.1006/gyno.1994.1241
Fowler, J. M. ; Hartenbach, E. M. ; Reynolds, H. T. ; Borner, J. ; Carter, J. R. ; Carlson, J. W. ; Twiggs, L. B. ; Carson, L. F. / Pelvic adhesion formation after pelvic lymphadenectomy : Comparison between transperitoneal laparoscopy and extraperitoneal laparotomy in a porcine model. In: Gynecologic Oncology. 1994 ; Vol. 55, No. 1. pp. 25-28.
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