Intérêts et voies d'abord de la stadification paraaortique laparoscopique dans les cancers avances du col utérin

The stage of a cervical neoplasm is defined on clinical criteria as reported by the International Federation of Gynecology and Obstetrics. Treatment planning however is based on this clinical stage, but moreover on histological variables obtained at surgical staging. Regarding advanced stage cervical cancer, the recommanded treatment consists in a radical radiotherapy together with concomitant chemotherapy. The target volume of the radiation treatment is directly dependent on the paraaortic lymph node status, the radiological evaluation of which remains unsatisfactory due to lack of sensitivity. We report our experience with two laparoscopic approaches (transperitoneal and retroperitoneal) allowing a histological paraaortic nodal status to be obtained prior to initiating the definitive treatment.