Para Aortic Lymph Node Dissection Borders

The paraaortic lymph node dissection begins over the right common iliac artery from the mid-level caudad to cephalad direction. A view from the USA.

Lymph Node Dissection Thoracic Key

The anatomic borders of dissection for a left-sided renal pelvis upper ureteral or midureteral tumor should at the minimum encompass the paraaortic preaortic and interaortocaval nodes from the level of the renal hilum to the aortic bifurcationFor a right-sided renal pelvis upper ureteral or midureteral tumor the removed node regions.

Para aortic lymph node dissection borders. Therefore the determination of the nodal status of patients is mandatory to optimally tailor adjuvant therapies and reduce local and distant recurrences. T12L1 or L12 3 Treat to a certain distance ie. 2 reported favorable outcomes of.

The inferior pulmonary vein and left and right bronchi form the borders of the dissection Level 8 nodes are dissected over the esophagus behind the inferior pulmonary vein. 1262011 The role of pelvic and paraaortic lymph node dissection in the surgical treatment of endometrial cancer. Lymphovascular invasion and lymph node LN status are strong predictive factors of recurrence.

1 contouring the PAs up to where the renal vessels exit the aorta. Associate Professor of Obstetrics and Gynecology. Division of Gynecologic Surgery Mayo Clinic Rochester MN 55905 USA Email.

3 cm or vertebral body above a known positive lymph node. 2L nodes are located to the left of the left lateral border of the trachea. 11162020 Aim The optimal surgical management strategy for para-aortic lymph node PALN metastasis has not attracted as much attention as surgery for liver or lung metastasis.

2 Treated up to vertebral body levels ie. Subcarinal zone Station 7. This major vessel can be found by following the left gonadal vein still attached to the peritoneum forming the ceiling of the space as it flows into the left renal vein.

Endometrial cancer located in the uterine fundus may follow. Para-aortic nodes ascending aorta or phrenic. The purpose of this retrospective study was to evaluate the oncologic outcomes after synchronous resection of PALN metastasis in left-sided colon and rectal cancer.

The upper border of the extraperitoneal paraaortic lymph node dissection is the left renal vein. This major vessel can be found by following the left gonadal vein still attached to the peritoneum forming the ceiling of the space as it flows into the left renal vein. 412020 The high para-aortic lymph node region contains important lymphatic channels including the lumbar lymphatic trunk the intestinal lymphatic trunk and the chyle cistern.

The role of the pelvic and paraaortic lymph node dissection for patients diagnosed with a gynecologic malignancy has evolved since the 1990s. For cervical cancer pelvic lymphadenectomy is. Left upper lobe tumors may metastasize to the subaortic lymph nodes station 5 and paraaortic nodes station 6.

Lower border of the aortic arch. 642016 The pelvic lymph nodes may be a site of early metastatic spread of cervical endometrial and ovarian cancers. Gastric cancer with extensive lymph node metastasis ELM which is defined as para-aortic lymph node PAN metastasis or bulky lymph nodes along the celiac splenic common or proper hepatic arteries or both of them is commonly regarded as unresectable.

Line tangential to the upper border of the aortic arch. These structures must be managed carefully to prevent damage that could lead to leakage of chyle and occurrence of chylous ascites. From the upper border of manubrium to the superior border of aortic arch.

For women treated with IMRT there are multiple ways to define the upper border of the field. This may be based on the current guidelines for para-aortic lymphadenectomy in GOG 210 and GOG LAP2 where the upper border of the para-aortic lymph node dissection is defined as the IMA. Lateral aortic lymph nodes are dissected from the infra-mesenteric region low paraaortic below the level of inferior mesenteric artery.

The upper border of the extraperitoneal paraaortic lymph node dissection is the left renal vein. Regional lymph node metastasis. Precaval and preaortic lymph nodes are dissected to the level of left renal vein.

While this survey only captures the reported practice patterns of 40 of SGO members there is clear variability among practicing gynecologic oncologist. Ovarian cancer has a predilection for lymphatic dissemination along the drainage routes of the ovarian vessels to the high para-aortic lymph nodes in proximity to the renal vessels. For each tumor site there is controversy about the extent of dissection complete lymphadenectomy versus lymph node sampling and the anatomic level of dissection that is required ie pelvic with or without paraaortic nodes.

Level 9 nodes are included in the pulmonary ligament. 642016 The para-aortic lymph nodes are a common site of metastatic spread of ovarian cancer and endometrial cancer. Endometrial cancer EC is the most common malignancy of the female reproductive tract and is increasing in incidence.

Anterior and lateral to the ascending aorta and aortic arch. Consequently surgical removal of pelvic lymph nodes is an important component of surgical staging for these cancers and may serve as a diagnostic procedure a therapeutic procedure or both. 4132017 Dissection around the main bronchus and subcarinal space from the right side.

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