腹腔镜腹膜外盆腔淋巴结切除术在妇科恶性肿瘤中的可行性。

Feasibility of laparoscopic extraperitoneal pelvic lymphadenectomy in gynecologic malignancies.

机构信息

Department of Obstetrics and Gynecology, China-Japan Friendship Hospital, Beijing 100029, People's Republic of China.

出版信息

Gynecol Oncol. 2011 Aug;122(2):281-4. doi: 10.1016/j.ygyno.2011.04.048. Epub 2011 May 31.

DOI:10.1016/j.ygyno.2011.04.048

PMID:21632097

Abstract

OBJECTIVE

The aim of this study is to evaluate the feasibility of laparoscopic extraperitoneal pelvic lymphadenectomy (LEPL) in gynecologic malignancies.

METHODS

Twenty-nine women with cervical, ovarian or endometrial cancer underwent laparoscopic extraperitoneal pelvic lymphadenectomy between July 2008 and December 2010. The operating time, nodal yield, blood loss and complications were recorded.

RESULTS

The number of patients with cervical, ovarian and endometrial carcinoma was 14, 3 and 12, respectively. The median age of patients was 48.9±12.6 years. The median body mass index was 25.6±4.8. Conversion to the transperitoneal laparoscopic approach was necessary in 6 patients for peritoneal tears causing CO(2) gas leakage. Among the remaining 23 patients, the median operating time for laparoscopic extraperitoneal pelvic lymphadenectomy was 69 min (range 50-126 min), and the median estimated blood loss was 20 ml (range 5-105 ml). The median total number of resected nodes was 26 (range 14-42), and complications related to the procedure were rare.

CONCLUSIONS

Laparoscopic extraperitoneal pelvic lymphadenectomy is a feasible and safe procedure. It can be used in gynecologic malignancies.

摘要

目的

本研究旨在评估妇科恶性肿瘤腹腔镜经腹外腹膜前盆腔淋巴结清扫术（LEPL）的可行性。

方法

2008 年 7 月至 2010 年 12 月，29 例宫颈癌、卵巢癌或子宫内膜癌患者接受了腹腔镜经腹外腹膜前盆腔淋巴结清扫术。记录手术时间、淋巴结检出数、出血量和并发症。

结果

宫颈癌、卵巢癌和子宫内膜癌患者分别为 14 例、3 例和 12 例。患者的中位年龄为 48.9±12.6 岁。中位体重指数为 25.6±4.8。由于腹膜撕裂导致 CO(2)气体泄漏，6 例患者需要转为经腹腹腔镜入路。在其余 23 例患者中，腹腔镜经腹外腹膜前盆腔淋巴结清扫术的中位手术时间为 69 分钟（50-126 分钟），中位估计出血量为 20 毫升（5-105 毫升）。中位切除淋巴结总数为 26 个（14-42 个），与手术相关的并发症罕见。