10-YEAR EXPERIENCE WITH EXTRAPERITONEAL PELVIOSCOPY FOR THE LYMPH-NODE STAGING OF PELVIC CANCERS

Background: In view of the surgical lymphadenectomy morbidity and of t he low accuracy of the preoperatory radiological investigations, minim al access surgery procedures are needed to assess lymph node involveme nt in pelvic cancers. Methods: Extraperitoneal pelvioscopy (EPP) is a direct vision endoscopy permitting the exploration of the retroperiton eal space of the pelvic area. Beginning 1/05/1995, 235 patients with a pparently resectable tumors underwent EPP for lymph node staging of 13 3 bladder, 89 prostate, 12 cervix, and one endometrium cancers. Result s: Lymph node involvement was discovered in 68 cases; the absence of l ymph node involvement was demonstrated in 155 cases; and there were 12 false-negative results of the procedure. The feasibility was of 98.3% . The global sensitivity and accuracy were, respectively, 85% and 94%. Conclusion: This study demonstrates that EPP is a safe and accurate p rocedure to evaluate the lymph node status of pelvic cancers.