Back to Search Start Over

Cardiophrenic and costophrenic lymph node resection via subxiphoid approach only

Authors :
Khatib G
Köse S
Bağır E
Küçükgöz Güleç Ü
Güzel AB
Vardar MA
Source :
Journal of the Turkish German Gynecological Association [J Turk Ger Gynecol Assoc] 2022 Jun 01; Vol. 23 (2), pp. 124-125. Date of Electronic Publication: 2022 Mar 10.
Publication Year :
2022

Abstract

When enlarged cardiophrenic lymph nodes (CPLN) are resected the impact on survival is still uncertain, but resection contributes to accurate staging and complete gross resection in advanced ovarian cancer. CPLN resection can be performed via video-assisted thoracic surgery or transabdominally through the subxiphoid or transdiaphragmatic routes. The subxiphoid approach is used to reach the prepericardiac nodes located in the anterior mediastinum. The transdiaphragmatic route is used to remove the costophrenic and supradiaphragmatic paracaval lymph nodes located in the middle and posterior mediastinum, respectively. However, the transdiaphragmatic approach necessitates diaphragm opening and, in most cases, liver mobilization. Costophrenic nodes can be resected through the subxiphoid route in appropriate patients without opening the diaphragm. Thus, the subxiphoid approach may be preferred to remove the costophrenic lymph nodes, in cases in whom diaphragm resection is not anticipated, and especially when the resection procedure is planned to include the prepericardiac nodes. In this video article, we present the method of resecting both prepericardiac and costophrenic lymph nodes using only the subxiphoid approach in a case of advanced ovarian cancer. The subxiphoid virtual space between the pericardium and diaphragm was developed. The observed and palpated CPLNs were dissected and excised from the prepericardiac and right latero-cardiac spaces. Thereafter, diaphragm peritoneum beneath the right costophrenic nodes was dissected. After identifying any enlarged costophrenic nodes by palpation, the sternal and costal diaphragmatic attachments were incised and the right latero-cardiac space was extended. When the single enlarged node was reached, it was grasped and pulled with curved-ring forceps and ultimately resected.<br />Competing Interests: Conflict of Interest: No conflict of interest is declared by the authors.<br /> (©Copyright 2022 by the Turkish-German Gynecological Education and Research Foundation)

Details

Language :
English
ISSN :
1309-0399
Volume :
23
Issue :
2
Database :
MEDLINE
Journal :
Journal of the Turkish German Gynecological Association
Publication Type :
Academic Journal
Accession number :
35263836
Full Text :
https://doi.org/10.4274/jtgga.galenos.2022.2021-9-2