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Case Reports
. 2016 May 24:17:33-7.
doi: 10.1016/j.gore.2016.05.006. eCollection 2016 Aug.

Short-term morbidity in transdiaphragmatic cardiophrenic lymph node resection for advanced stage gynecologic cancer

C J LaFargue  1 , B T Sawyer  1 , R E Bristow  2
Affiliations
Case Reports

Short-term morbidity in transdiaphragmatic cardiophrenic lymph node resection for advanced stage gynecologic cancer

C J LaFargue et al. Gynecol Oncol Rep. .

Abstract

Ovarian cancer is commonly diagnosed at an advanced stage, with disease involving the upper abdomen. The finding of enlarged cardiophrenic lymph nodes (CPLNs) on pre-operative imaging often indicates the presence of malignant spread to the mediastinum. Surgical resection of CPLN through a transdiaphragmatic approach can help to achieve cytoreduction to no gross residual. A retrospective chart review was conducted on all patients who underwent transdiaphragmatic cardiophrenic lymph node resection from 8/1/11 through 2/1/15. All relevant pre-, intra-, and post-operative characteristics and findings were recorded. A brief description of the surgical technique is included for reference. Eleven patients were identified who had undergone transdiaphragmatic resection of cardiophrenic lymph nodes. Malignancy was identified in 18/21 (86%) of total lymph nodes submitted. The median number of post-operative days was 7. The overall post-operative morbidity associated with CPLN resection was low, with the most common finding being a small pleural effusion present on chest x-ray between POD# 3-5 (55%). Transdiaphragmatic CPLN resection is a feasible procedure with relatively minor short-term post-operative morbidities that can be used to achieve cytoreduction to no gross residual disease.

Keywords: Cardiophrenic lymph nodes; Cytoreductive surgery; Diaphragm resection; Ovarian cancer; Post-operative morbidity.

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Figures

Fig. 1
Fig. 1
Pre-operative CT scan demonstrating enlarged cardiophrenic lymph node in mediastinum.
Fig. 2
Fig. 2
Cardiophrenic fat pad is grasped with Babcock clamp and excised using vessel sealing-cutting device via diaphragmatic defect.
See this image and copyright information in PMC

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