Yamamoto R, Saitoh T, Kusaka T, Todo Y, Takeda M, Okamoto K, Nomura E, Ebina Y, Kaneuchi M, Sakuragi N, Fujimoto S
Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Japan.
Jpn J Clin Oncol. 2000 Sep;30(9):397-400.
The occurrence of pelvic lymphocysts is an important complication following systematic lymphadenectomy for gynecological malignancies. We employed a procedure to prevent vaginal shortening following radical hysterectomy and we examined whether this procedure could be effective in preventing pelvic lymphocyst formation.
We studied the incidence of lymphocysts in 190 patients with 84 cervical cancers, 74 endometrial cancers and 32 ovarian cancers, using computed tomographic examination at 3 and 6 months subsequent to the surgery. The surgery included radical hysterectomy and a procedure to prevent vaginal shortening (101), modified radical hysterectomy (79) and simple hysterectomy (7), with systematic lymphadenectomy.
There was a significant difference in the incidence of pelvic lymphocysts between cervical cancer (4.8%) and ovarian cancer (18.8%). The postoperative incidence of lymphocyst formation in patients undergoing radical hysterectomy with the procedure to prevent vaginal shortening (5.9%) was significantly lower than in those who underwent modified radical hysterectomy (15.2%).
Our procedure to prevent vaginal shortening could be effective in preventing not only the shortening of the vagina but also the occurrence of pelvic lymphocysts in patients undergoing radical hysterectomy with systematic lymphadenectomy for gynecological malignancies.
盆腔淋巴囊肿的发生是妇科恶性肿瘤系统性淋巴结清扫术后的一项重要并发症。我们采用了一种预防根治性子宫切除术后阴道缩短的方法，并研究了该方法是否能有效预防盆腔淋巴囊肿的形成。
我们对190例患者进行了研究，其中包括84例宫颈癌、74例子宫内膜癌和32例卵巢癌患者，在术后3个月和6个月时采用计算机断层扫描检查淋巴囊肿的发生率。手术包括根治性子宫切除术及预防阴道缩短的方法（101例）、改良根治性子宫切除术（79例）和单纯子宫切除术（7例），均进行了系统性淋巴结清扫。
宫颈癌患者（4.8%）和卵巢癌患者（18.8%）的盆腔淋巴囊肿发生率存在显著差异。采用预防阴道缩短方法的根治性子宫切除患者术后淋巴囊肿形成的发生率（5.9%）显著低于接受改良根治性子宫切除术的患者（15.2%）。
我们预防阴道缩短的方法不仅可以有效防止阴道缩短，而且对于接受系统性淋巴结清扫的妇科恶性肿瘤根治性子宫切除患者，还能有效预防盆腔淋巴囊肿的发生。
