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[妇科肿瘤腹腔镜淋巴结清扫术的并发症。915例患者的1102例手术系列报道]

[Complications of laparoscopic lymphadenectomy in gynaecologic oncology. A series of 1102 procedures in 915 patients].

作者信息

Cartron G, Leblanc E, Ferron G, Martel P, Narducci F, Querleu D

机构信息

Institut Claudius-Regaud, 20-24, rue du Pont-St-Pierre, 31052 Toulouse cedex, France.

出版信息

Gynecol Obstet Fertil. 2005 May;33(5):304-14. doi: 10.1016/j.gyobfe.2005.04.002.

Abstract

OBJECTIVE

Evaluate complications of pelvic and para aortic laparoscopic lymphadenectomies in oncologic gynaecology to confirm the surgical approach and include it in current therapy.

PATIENTS AND METHODS

From December 1998 to March 2004, 915 patients underwent pelvic and/or aortic lymphadenectomies by laparoscopy. Among them, 771 were operated on at the centre Oscar-Lambret (Lille, France), whereas 144 underwent surgery at the institut Claudius-Regaud (Toulouse, France). Laparoscopic lymphadenectomies could be indicated along with other procedures in 98 early adnexal carcinomas, in 237 cervical carcinomas and 216 locally advanced cervical carcinomas. It may also be included as part of cancer therapy with (radical) hysterectomy/trachelectomy in 161 endometrial and 203 up front surgical cervical carcinomas.

RESULTS

A total of 1102 pelvic and aortic lymphadenectomies have been performed: 714 pelvic (694 trans peritoneal, 20 extra peritoneal) and 388 aortic lymphadenectomies (154 transperitoneal, 234 extraperitoneal). Seventeen open surgeries (1.85%) were necessary for technical reasons or complications.

DISCUSSION AND CONCLUSIONS

Laparoscopic lymphadenectomies are safe and accurate with no more complications than by laparotomy and no death up to now.

摘要

目的

评估妇科肿瘤腹腔镜盆腔及腹主动脉旁淋巴结清扫术的并发症,以确定手术方式并将其纳入当前治疗方案。

患者与方法

1998年12月至2004年3月,915例患者接受了腹腔镜盆腔和/或主动脉淋巴结清扫术。其中,771例在奥斯卡 - 兰布雷中心(法国里尔)接受手术,144例在克劳迪乌斯 - 雷高研究所(法国图卢兹)接受手术。腹腔镜淋巴结清扫术可与其他手术一起用于98例早期附件癌、237例宫颈癌和216例局部晚期宫颈癌。它也可作为(根治性)子宫切除术/宫颈切除术治疗癌症的一部分,用于161例子宫内膜癌和203例前期手术的宫颈癌。

结果

共进行了1102例盆腔和主动脉淋巴结清扫术:714例盆腔清扫术(694例经腹腔,20例经腹膜外)和388例主动脉淋巴结清扫术(154例经腹腔,234例经腹膜外)。因技术原因或并发症,17例转为开放手术(1.85%)。

讨论与结论

腹腔镜淋巴结清扫术安全、准确,并发症不比开腹手术多,且至今无死亡病例。

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