Introduction/Background Lymph node status is one of the main prognostic factor that play an important role in the postoperative treatment strategy.
The goal of the study was to compare the rate of complications after laparoscopic systematic lymphadenectomy versus sentinel node biopsy in early endometrial and cervical cancer.
Methodology The retrospective study during 2018–2022 years included 96 patients with early endometrial cancer (FIGO stage IB-IIA, G2–3 endometrioid adenocarcinoma) and early cervical cancer (FIGO stage IB-IIA, without parametrial invasion). In 89 from 96 patients (92,7%) detected comorbid diseases (hypertension, obesity, diabetes mellitus etc). All patients underwent total laparoscopic hysterectomy (TLH) with pelvic lymph node dissection as a part of surgical staging and divided into two homogenous groups . The first group consisted of 40 patients who underwent systematic pelvic lympadenectomy (PLE), the second group included 56 patients who underwent indocyanine green (ICG) marked sentinel lymph node (SLN) sampling.
Results Ultrasound scalpel was used for lympadenectomy in both groups. The lymph nodes involvement were detected in 3 (7,5%) cases in the first group and no metastaseswere detected in the second group. Operation time in the first group was significantly longer on 35,4 min than in second group (115,8+11,5) min and 80,4+9,2 min, respectivelly). In the first group there were postoperative complications: obturator nerve damage in 1 patient (2,5%), that was diagnosed and reconstructed intraoperatively, lymphocele - in 2 cases (5%), prolonged lymphedema - in 3 patients (7,5%). urogenital fistula- in 1 patient who received preoperative radiotherapy. No complications there were in the second group. In both group there were no bleeding and intraoperative pelvic organ damages.
Conclusion The use of laparoscopic ICG marked SLN sampling for early endometrial and cervical cancer is less traumatic, reduces the rate of intra- and postoperative complications, shortens the time of surgery and can also be proposed for high risk patients.
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