V-Notes Sentinel Lymph Node Staging for Endometrial Cancer: A Systematic Review

Area of Science:

• Gynecologic Oncology
• Minimally Invasive Surgery
• Surgical Pathology

Background:

• Sentinel lymph node (SLN) mapping is crucial for staging early endometrial cancer, balancing diagnostic accuracy with reduced surgical morbidity.
• Vaginal Natural Orifice Transluminal Endoscopic Surgery (V-NOTES) presents a novel minimally invasive approach for SLN mapping, potentially enhancing patient recovery and cosmetic outcomes.

Purpose of the Study:

• To evaluate the feasibility, safety, and efficacy of V-NOTES for SLN mapping in patients with early-stage endometrial cancer.
• To synthesize current evidence on V-NOTES SLN mapping outcomes, including detection rates and perioperative parameters.

Main Methods:

• A comprehensive literature search was performed across major databases to identify studies on V-NOTES for SLN mapping in endometrial cancer.
• Included studies comprised observational cohorts, case reports, and case series, analyzing data on patient demographics, surgical approaches, tracers, and outcomes.

Main Results:

• Twelve studies were included, with a mean patient age of 59.6 years; many patients were overweight or obese.
• V-NOTES achieved a high overall SLN detection rate (98.19%) and bilateral detection rate (93.7%), with low complication rates (3.9%) and short hospital stays (2.4 days).
• Indocyanine green (ICG) was the predominant tracer used, with both transperitoneal and retroperitoneal V-NOTES approaches documented.

Conclusions:

• V-NOTES is a feasible and safe technique for SLN mapping in early endometrial cancer, demonstrating high detection rates and favorable perioperative results.
• Further prospective research with comparative analyses is necessary to confirm V-NOTES efficacy against traditional methods and define optimal patient selection criteria.