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采用单独腹股沟切口行外阴切除术及腹股沟股淋巴结清扫术后的并发症

Postoperative complications after vulvectomy and inguinofemoral lymphadenectomy using separate groin incisions.

作者信息

Gaarenstroom K N, Kenter G G, Trimbos J B, Agous I, Amant F, Peters A A W, Vergote I

机构信息

Department of Gynecology, Leiden University Medical Center, Leiden, the Netherlands.

出版信息

Int J Gynecol Cancer. 2003 Jul-Aug;13(4):522-7. doi: 10.1046/j.1525-1438.2003.13304.x.

Abstract

The focus of this study was to document postoperative complications after vulvectomy and inguinofemoral lymphadenectomy using separate incisions. Data from 172 consecutive patients with newly diagnosed carcinoma of the vulva were studied. One hundred and one patients primarily treated with modified radical vulvectomy and complete inguinofemoral lymphadenectomy using separate groin incisions (n = 187) were included in this study. One or more complications were documented in 77 of the 101 (76%) patients. Complications after groin dissection were observed in 66% of the patients. The main complications were wound breakdown (17%) and/or infection (39%) of the groin, lymphocyst formation (40%), and lymphedema (28%). In 98 of 187 (52%) groin dissections, one or more complications were documented. The presence of lymph node metastases, postoperative radiation, age older than 65 years, and removal of the vena saphena magna were not significant risk factors for the occurrence of complications. The occurrence of early complications after groin dissection was significantly related to the late-complication lymphedema (P = 0.002). Our results confirm relatively high rates of wound breakdown, infection, lymphocyst formation, and lymphedema even with separate groin incisions. The occurrence of early complications was related to lymphedema. No other risk factors could be identified.

摘要

本研究的重点是记录采用单独切口进行外阴切除术和腹股沟股淋巴结清扫术后的并发症。对172例新诊断为外阴癌的连续患者的数据进行了研究。本研究纳入了101例主要接受改良根治性外阴切除术和采用单独腹股沟切口进行的完全腹股沟股淋巴结清扫术的患者(共187处切口)。101例患者中有77例(76%)记录了一种或多种并发症。66%的患者观察到腹股沟清扫术后出现并发症。主要并发症包括腹股沟伤口裂开(17%)和/或感染(39%)、淋巴囊肿形成(40%)以及淋巴水肿(28%)。在187处腹股沟清扫切口中,有98处(52%)记录了一种或多种并发症。淋巴结转移、术后放疗、年龄大于65岁以及大隐静脉切除并非并发症发生的显著危险因素。腹股沟清扫术后早期并发症的发生与晚期并发症淋巴水肿显著相关(P = 0.002)。我们的结果证实,即使采用单独的腹股沟切口,伤口裂开、感染、淋巴囊肿形成和淋巴水肿的发生率也相对较高。早期并发症的发生与淋巴水肿有关。未发现其他危险因素。

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