Pelvic Lymphadenectomy

Cervical cancer lymphadenectomy procedure encompasses pelvic lymphadenectomy and, when indicated, low para-aortic lymphadenectomy. The pelvic lymphadenectomy encompasses comprehensive systematic lymph node dissection, sentinel lymph node biopsy, and sentinel lymph node mapping excision. The systematic pelvic lymphadenectomy procedure adheres rigorously to the cervical cancer lymphadenectomy extent as defined by the Cibula Type III classification, as executed by the author’s team. Pelvic lymphadenectomy encompasses several aspects: the cranial aspect reveals the bifurcation of the common iliac vessels, the caudal aspect exposes the deep circumflex iliac vein, the dorsal aspect reveals the lymph nodes beneath the obturator nerve and pelvic floor fascia, and the lateral aspect reveals the lumbosacral trunk [1, 2]. In accordance with the findings from the LACC trial and the consensus of Chinese experts [3, 4], our team exclusively conducted minimally invasive surgery on patients with a clinical stage of ≤IB1, and preoperative imaging assessment showed no clinically positive lymph nodes. Conversely, the open surgery group encompassed patients with cervical cancer up to stage ≤IIA1. For patients exhibiting tumor diameter >2 cm, special pathological types, or intraoperative incidental detection of positive pelvic lymph nodes, routine para-aortic lymphadenectomy was performed.