Laparoscopic Lymph Node Biopsies: A Safe and Valuable Sampling Method for Intra-Abdominal Lymphadenopathy with a High Diagnostic Yield

Abstract

Introduction: Histopathological analysis of lymph nodes is mandatory for diagnosis of conditions such as lymphoma and to confirm spread of malignant disease. In cases where the node cannot be sampled percutaneously, laparoscopy is emerging as a useful tool for biopsy of deep intra-abdominal lymph nodes with reduced morbidity and mortality when compared to the previous gold standard laparotomy. Methods: This series describes 15 cases of laparoscopic lymph node biopsy over a period of 6 years. It is a retrospective case note analysis for patients who had the biopsy as an individual procedure. Results: 47% (n=7) procedures were for the diagnosis of malignant metastatic spread from a known primary, with 53% (n=8) for primary diagnosis. The node was taken whole in 93% cases (n=14), with a conversion rate of 13.6% (n=2) due to difficulties with access. There was one non-diagnostic result (12.5%). Discussion: This series shows diagnostic rates higher than those previously published for percutaneous lymph node sampling, which has great implications of management of potential malignancy. The conversion rates in this series are similar to those previously published, showing a procedure with low morbidity but high diagnostic yield, which should be considered in the management of cases where the malignant nature of a lymph node is in question.