Retroperitoneal vascular aberrations increase the risk of vascular injury during lymphadenectomy in gynecologic cancers

Arch Gynecol Obstet. 2012 Aug;286(2):449-55. doi: 10.1007/s00404-012-2285-7. Epub 2012 Mar 11.


Purpose: To investigate the frequency of aberrations of retroperitoneal great vessels in patients with gynecologic cancers who were scheduled for pelvic and paraaortic lymphadenectomy, and to document the vascular complications which occurred during lymphadenectomy as well as the relationship of these vascular complications with vascular aberrations.

Methods: Patients with gynecologic cancers underwent a routine preoperative abdominal multi-detector computer tomography, and an intraoperative search for aberrations of the great vessels in the retroperitoneal region was undertaken. Intraoperative vascular complications were recorded and their relations to vascular aberrations were analyzed.

Results: The rate of vascular aberrations detected preoperatively by multi-detector computed tomography was 24.3 %. Vascular injuries occurred in six patients (16.2 %) during lymphadenectomy. Rate of intraoperative vascular injuries was significantly higher in patients who had vascular aberrations of retroperitoneal great vessels (44.4 vs. 7.1 %, p = 0.022).

Conclusions: Aberrations of retroperitoneal vessels are not uncommon and may increase the risk of vascular complications during lymphadenectomy. The risk of these complications may be decreased if aberrations are detected preoperatively.

MeSH terms

  • Adult
  • Aged
  • Carcinoma / blood supply
  • Carcinoma / diagnostic imaging
  • Carcinoma / surgery*
  • Female
  • Genital Neoplasms, Female / blood supply
  • Genital Neoplasms, Female / diagnostic imaging
  • Genital Neoplasms, Female / surgery*
  • Gynecologic Surgical Procedures / adverse effects*
  • Gynecologic Surgical Procedures / methods
  • Humans
  • Iliac Artery / abnormalities*
  • Iliac Artery / diagnostic imaging
  • Intraoperative Complications / diagnostic imaging
  • Intraoperative Complications / etiology
  • Intraoperative Complications / prevention & control
  • Lymph Node Excision / adverse effects*
  • Middle Aged
  • Multidetector Computed Tomography
  • Retroperitoneal Space / blood supply
  • Retroperitoneal Space / diagnostic imaging
  • Risk
  • Vascular System Injuries / etiology*