144 A complicated case of paraaortic nodal dissection in a woman with fallopian tube cancer

• Published in: International journal of gynecological cancer Vol. 31; no. Suppl 3; p. A201
• Main Authors: Iavazzo, CR, Fotiou, A, Kokkali, K, Lekka, S, Giannoulopoulos, D, Giannakas, P, Vorgias, G
• Format: Journal Article
• Language: English
• Published: Oxford BMJ Publishing Group Ltd 12.10.2021; BMJ Publishing Group LTD
• Subjects: Cancer; Dissection; Fallopian tubes; Genital cancers; Gynecological cancer; Lymphatic system; Ovarian cancer; Ovaries; Patients
• ISSN: 1048-891X; 1525-1438
• DOI: 10.1136/ijgc-2021-ESGO.345

Introduction/Background*Paraaortic lymph node dissection is a challenging surgical procedure. Recent data mentioned that bulky nodal disease in ovarian/fallopian tube cancer patients stage IIB and above should be dissected in fallopian tube cancer patients that optimal primary cytoreduction has been achieved.MethodologyA challenging paraaortic lymph node dissection of a nodal block arising from fallopian tube cancer in a 76 years old patient is presented in this surgical video. Patient has been diagnosed with ovarian/fallopian tube cancer. Her CA 125 was 2161 IU/ml and her preoperative imaging has revealed a mass of right adnexa 7 x 3 cm, a metastatic abdominal mass involving the transverse colon and paraaortic lymph node 6 cm in dimension.Result(s)*Abdominal hysterectomy, omentectomy, resection of the transverse colon, peritonectomies and dissection of the paraaortic nodal mass took place. No macroscopic residual disease was observed at the end of the procedure.Conclusion*Removal of bulky nodal disease is indicated for patients with advanced ovarian/fallopian tube cancer. As applies in any paraaortic/retroperitoneal lymph node dissection resection of bulky lymph nodes can lead in intra or postoperative complications. Therefore, awareness of anatomical landmarks and anatomic variation are of paramount importance.