{Reference Type}: Journal Article
{Title}: Para-aortic lymph node dissection with or without nerve-sparing in gynecological malignancies.
{Author}: Wen Q;Zhu Y;Zhou H;Yang L;Shao F;Zhu T;Shao Z;
{Journal}: J Gynecol Oncol
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jul 2
{Factor}: 4.756
{DOI}: 10.3802/jgo.2025.36.e9
{Abstract}: <B>OBJECTIVE: </B>Para-aortic lymph node dissection (PALND) is a widely used treatment that causes many complications. This study is to evaluate the efficacy and safety of nerve-sparing para-aortic lymph node dissection (NSPALND) by comparing it with conventional PALND in gynecological malignancies and to prove whether locating the superior hypogastric plexus (SHP) can help reveal the para-aortic nerves.<BR><B>METHODS: </B>This is a retrospective study of the patients who underwent para-aortic lymphadenectomy from January 2020 to December 2022 at Zhejiang Cancer Hospital. All of them were divided into NSPALND and PALND groups according to whether or not nerve-sparing was performed. The surgical, functional and oncological outcomes were evaluated.<BR><B>RESULTS: </B>There were 43 patients enrolled, of which, 20 patients underwent NSPALND and 23 patients underwent PALND. The para-aortic nerves were successfully revealed by locating the SHP in all 20 cases of NSPALND. The post-operative anal exhaust time in the NSPALND group was significantly shorter than that in the PALND group (2.5 vs. 4 days, p=0.006), and the incidence of acute intestinal obstruction in the NSPALND group was significantly lower than that in the PALND group (10% vs. 39%, p=0.029). There was no difference between the two groups in terms of catheterization duration, urinary retention, dysuria, as well as the number of lymph nodes removed and the para-aortic recurrence rate.<BR><B>CONCLUSIONS: </B>NSPALND can significantly reduce the rate of acute intestinal obstruction and improve post-operative intestinal function. Locating the SHP and using it as an anatomical landmark to reveal the para-aortic nerves is feasible. Its exact clinical value needs to be further studied.