Extraperitoneal para-aortic node dissection through an upper abdominal incision

A surgical technique for para-aortic lymph node evaluation for metastatic tumor by the extraperitoneal approach is described. The procedure is devised to avoid gastrointestinal complications frequently found after transperitoneal evaluation of the para-aortic area followed by extended field irradiation. The surgical procedure was performed in 20 patients. Nine patients treated with 6000 rads extended field irradiation remained without gastrointestinal complications after 3 to 16 months of follow-up.