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[Surgical anatomy of the lymphatic drainage of the bladder]
V Ravery1, D K Chopin, C C Abbou
1Service d'Urologie, Hôpital Henri Mondor, Creteil.
Descriptive anatomy teaches us that the lymphatic drainage of the bladder converges directly on to the middle and internal chains of the external iliac nodes, but never on to the external chain, sometimes on a sacral common iliac node and widely on internal iliac nodes. Surgical observations confirm this: no lymph node metastasis in the external chain of external iliac nodes is noticed, nor common iliac adenopathy without upstream invasion. On the basis of these descriptions, lymphadenectomy was performed from inguinal ligament to iliac bifurcation. Anatomical data largely explain pelvic recurrences due to the existence of unremoved common iliac nodes or unrecognized hypogastric nodes because of difficult access without sacrificing efferent branches of internal iliac artery.
Descriptive anatomy teaches us that the lymphatic drainage of the bladder converges directly on to the middle and internal chains of the external iliac nodes, but never on to the external chain, sometimes on a sacral common iliac node and widely on internal iliac nodes. Surgical observations confirm this: no lymph node metastasis in the external chain of external iliac nodes is noticed, nor common iliac adenopathy without upstream invasion. On the basis of these descriptions, lymphadenectomy was performed from inguinal ligament to iliac bifurcation. Anatomical data largely explain pelvic recurrences due to the existence of unremoved common iliac nodes or unrecognized hypogastric nodes because of difficult access without sacrificing efferent branches of internal iliac artery.
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