Laparoscopic ultrasonography-assisted retroperitoneal lymph node sampling in patients evaluated for stomach cancer recurrence

Abstract

Objective: The precise localization of target lymph nodes during laparoscopic biopsy can often be technically challenging. The purpose of this series was to report 2 patients who successfully underwent laparoscopic para-aortic lymph node sampling with the assistance of laparoscopic ultrasonography (LUS).

Methods: We describe 2 patients previously treated for gastric cancer who later had suspicious retroperitoneal lymphadenopathy detected by computed tomography. They received LUS-assisted lymph node biopsies for histologic evaluation.

Results: Laparoscopic ultrasonography precisely localized the target lymph nodes, which measured 1.4 and 1.5 cm, respectively, in both patients. A transperitoneal laparoscopic approach and target lymph node sampling were successfully performed. No procedure-related technical difficulties or immediate complications occurred. The 2 patients were histologically proven to have nodal tumor recurrence and tuberculous lymphadenopathy, respectively.

Conclusions: Precise localization of a small lymph node located deep in the abdomen can be readily performed by intraoperative LUS.