Pelvic and aortic lymphadenectomy

Lymphatics are the main pathway for distant spread of gynecologic cancers. Therefore, pelvic and aortic lymphadenectomy are preformed for staging and therapeutic purposes. In both cases, strict indications and well-defined boundaries of dissection should be set and a significant number of nodes removed if the best prognostic information and the maximum therapeutic benefit are to be gained from the procedure. Adequate perioperative management, proper surgical technique, and awareness of the vascular and urinary anomalies more frequently encountered are all of utmost importance in order to decrease perioperative complications, blood loss, operative time, and postoperative stay.