Holub Z, Jabor A, Kliment L, Lukac J, Voracek J
Department of Obstetrics and Gynecology, Endoscopic Training Center, Baby Friendly Hospital, Kladno, Czech Republic.
J Laparoendosc Adv Surg Tech A. 2002 Jun;12(3):175-80. doi: 10.1089/10926420260188065.
To assess and compare perioperative parameters in two groups of patients treated by different laparoscopic techniques of lymph node dissection (LND) for gynecologic cancer.
Between April 1996 and March 2001, 59 consecutive women with microinvasive cervical cancer (N = 5) or clinical stage I endometrial cancer (N = 54) underwent laparoscopic LND during a primary staging procedure using an electrosurgery (ELC) or ultrasonic (US) operative technique. The two groups were compared for perioperative outcomes. Differences between the two groups were determined by the Wilcoxon's rank-sum test.
Laparoscopic LND and other staging procedures were completed successfully in 58 women (98.3%). There were no statistically significant differences between the groups with regard to perioperative outcomes (operation time, time for LND, blood loss, hospital stay, complications), but there was a significant difference (P = 0.0008) in the number of lymph nodes harvested: a mean of 13.7 in the ELC group and 17.5 in the US group. The pathologists found that the reading of histology slides was easier after US dissections because of the greater depth of thermal injury in the lymphatic tissue in ELC group.
The US operative technique ensures efficient coagulation, cutting, dissection, and grasping for laparoscopic LND in patients with cervical and endometrial cancer.
评估和比较两组采用不同腹腔镜淋巴结清扫术（LND）治疗妇科癌症患者的围手术期参数。
1996年4月至2001年3月期间，59例连续的微浸润宫颈癌患者（n = 5）或临床I期子宫内膜癌患者（n = 54）在初次分期手术中采用电外科手术（ELC）或超声（US）手术技术进行腹腔镜LND。比较两组的围手术期结果。两组之间的差异通过Wilcoxon秩和检验确定。
58例女性（98.3%）成功完成腹腔镜LND和其他分期手术。两组在围手术期结果（手术时间、LND时间、失血量、住院时间、并发症）方面无统计学显著差异，但在获取的淋巴结数量上有显著差异（P = 0.0008）：ELC组平均为13.7个，US组为17.5个。病理学家发现，由于ELC组淋巴组织热损伤深度更大，US清扫后组织学切片的判读更容易。
US手术技术可确保对宫颈癌和子宫内膜癌患者进行腹腔镜LND时有效凝血、切割、解剖和抓取。
