Transdiaphragmatic resection of enlarged cardiophrenic lymph node during interval debulking surgery for advanced ovarian cancer
Surgery in advanced ovarian malignancy is indicated when complete debulking can be achieved. In patients with disease above the diaphragm, achieving R0 can present a surgical challenge and bring into question the feasibility of surgery (Soleymani majd et al., 2016; Pinelli et al., 2019).We present a...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-08-01
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| Series: | Gynecologic Oncology Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578921001119 |
| _version_ | 1818909873972183040 |
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| author | Susan Addley Matteo Morotti Ciro Pinelli Hooman Soleymani majd |
| author_facet | Susan Addley Matteo Morotti Ciro Pinelli Hooman Soleymani majd |
| author_sort | Susan Addley |
| collection | DOAJ |
| description | Surgery in advanced ovarian malignancy is indicated when complete debulking can be achieved. In patients with disease above the diaphragm, achieving R0 can present a surgical challenge and bring into question the feasibility of surgery (Soleymani majd et al., 2016; Pinelli et al., 2019).We present a surgical video demonstrating the technique of cardiophrenic lymph node dissection in advanced ovarian malignancy.Following type 3 liver mobilisation, the diaphragm is stripped and muscle opened to gain access to the thoracic cavity. Transdiaphragmatic assessment of the cardiophrenic lymph node bundle is performed. A bulky node – correlating with pre-operative radiology – is removed using an advanced energy device, maintaining the surrounding lung parenchyma and underlying pericardium safely in view throughout. The diaphragmatic is closed using a loop non-absorbable suture and placing continuous, locking sutures (Addley et al., 2021).We demonstrate that the presence of cardiophrenic lymphadenopathy is not an obstacle to complete debulking. By employing a trans-diaphragmatic technique to gain thoracic access, involved cardio-phrenic nodes – and hence all visible disease – can be surgically excised, successfully achieving R0 status and offering patients optimal prognosis. |
| first_indexed | 2024-12-19T22:33:50Z |
| format | Article |
| id | doaj.art-14bee203a1c746c180cbb7794883092c |
| institution | Directory Open Access Journal |
| issn | 2352-5789 |
| language | English |
| last_indexed | 2024-12-19T22:33:50Z |
| publishDate | 2021-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj.art-14bee203a1c746c180cbb7794883092c2022-12-21T20:03:16ZengElsevierGynecologic Oncology Reports2352-57892021-08-0137100807Transdiaphragmatic resection of enlarged cardiophrenic lymph node during interval debulking surgery for advanced ovarian cancerSusan Addley0Matteo Morotti1Ciro Pinelli2Hooman Soleymani majd3Oxford University Hospitals NHS Foundation Trust, United KingdomOxford University Hospitals NHS Foundation Trust, United KingdomOxford University Hospitals NHS Foundation Trust, United KingdomCorresponding author at: Department of Gynae-Oncology, Churchill Hospital, Old Road, Headington, OX3 7LE, United Kingdom.; Oxford University Hospitals NHS Foundation Trust, United KingdomSurgery in advanced ovarian malignancy is indicated when complete debulking can be achieved. In patients with disease above the diaphragm, achieving R0 can present a surgical challenge and bring into question the feasibility of surgery (Soleymani majd et al., 2016; Pinelli et al., 2019).We present a surgical video demonstrating the technique of cardiophrenic lymph node dissection in advanced ovarian malignancy.Following type 3 liver mobilisation, the diaphragm is stripped and muscle opened to gain access to the thoracic cavity. Transdiaphragmatic assessment of the cardiophrenic lymph node bundle is performed. A bulky node – correlating with pre-operative radiology – is removed using an advanced energy device, maintaining the surrounding lung parenchyma and underlying pericardium safely in view throughout. The diaphragmatic is closed using a loop non-absorbable suture and placing continuous, locking sutures (Addley et al., 2021).We demonstrate that the presence of cardiophrenic lymphadenopathy is not an obstacle to complete debulking. By employing a trans-diaphragmatic technique to gain thoracic access, involved cardio-phrenic nodes – and hence all visible disease – can be surgically excised, successfully achieving R0 status and offering patients optimal prognosis.http://www.sciencedirect.com/science/article/pii/S2352578921001119 |
| spellingShingle | Susan Addley Matteo Morotti Ciro Pinelli Hooman Soleymani majd Transdiaphragmatic resection of enlarged cardiophrenic lymph node during interval debulking surgery for advanced ovarian cancer Gynecologic Oncology Reports |
| title | Transdiaphragmatic resection of enlarged cardiophrenic lymph node during interval debulking surgery for advanced ovarian cancer |
| title_full | Transdiaphragmatic resection of enlarged cardiophrenic lymph node during interval debulking surgery for advanced ovarian cancer |
| title_fullStr | Transdiaphragmatic resection of enlarged cardiophrenic lymph node during interval debulking surgery for advanced ovarian cancer |
| title_full_unstemmed | Transdiaphragmatic resection of enlarged cardiophrenic lymph node during interval debulking surgery for advanced ovarian cancer |
| title_short | Transdiaphragmatic resection of enlarged cardiophrenic lymph node during interval debulking surgery for advanced ovarian cancer |
| title_sort | transdiaphragmatic resection of enlarged cardiophrenic lymph node during interval debulking surgery for advanced ovarian cancer |
| url | http://www.sciencedirect.com/science/article/pii/S2352578921001119 |
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