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腹腔镜妇科恶性肿瘤淋巴结切除术:七年经验评估手术方法和结果。

Laparoscopic lymphadenectomy for gynecologic malignancies: evaluation of the surgical approach and outcomes over a seven-year experience.

机构信息

Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung-dong Jongno-gu, Seoul 110-746, Republic of Korea.

出版信息

Arch Gynecol Obstet. 2012 Mar;285(3):823-9. doi: 10.1007/s00404-011-2056-x. Epub 2011 Aug 17.

DOI:10.1007/s00404-011-2056-x
PMID:21847586
Abstract

PURPOSE

The purpose of this study was to evaluate the feasibility and efficacy of laparoscopic lymphadenectomy in patients with gynecologic malignancies and improve upon the existing published data regarding laparoscopic lymphadenectomy.

METHODS

We conducted a retrospective chart review of 225 patients with various gynecologic malignancies who had undergone laparoscopic pelvic lymphadenectomy (LPL) and/or laparoscopic para-aortic lymphadenectomy (LPAL) at Kangbuk Samsung Hospital between November 2003 and October 2010.

RESULTS

One hundred and seventy-two patients underwent both LPL and LPAL, 47 patients underwent LPL alone, and six patients underwent a repeat laparoscopic lymphadenectomy. The median age and body mass index of the patients were 49.4 years (range 23-79 years) and 24.2 kg/m(2) (range 17.5-37.2 kg/m(2)). The median numbers of harvested pelvic and para-aortic lymph nodes were 25.9 (range 3-63) and 10.6 (range 1-34), respectively. The median operating times for the LPL and LPAL were 72.3 min (range 40-120 min) and 40 min (range 20-70 min), respectively. There were seven cases of major vessel injuries, two lymphocytes, two lymphedemas, and two chylous ascites. There was no unplanned conversion to laparotomy.

CONCLUSIONS

Laparoscopic lymphadenectomy can be considered a technically feasible and safe procedure and has become the alternative modality in the field of gynecologic oncology surgery. And our results could reinforce the existing published data regarding laparoscopic lymphadenectomy.

摘要

目的

本研究旨在评估妇科恶性肿瘤患者腹腔镜下淋巴结切除术的可行性和疗效,并对现有的腹腔镜下淋巴结切除术相关数据进行改进。

方法

我们对 2003 年 11 月至 2010 年 10 月在康伯三星医院接受腹腔镜盆腔淋巴结切除术(LPL)和/或腹腔镜腹主动脉旁淋巴结切除术(LPAL)的 225 例妇科恶性肿瘤患者进行了回顾性图表审查。

结果

172 例患者同时接受了 LPL 和 LPAL,47 例患者仅接受了 LPL,6 例患者接受了重复腹腔镜淋巴结切除术。患者的中位年龄和体重指数分别为 49.4 岁(范围 23-79 岁)和 24.2kg/m²(范围 17.5-37.2kg/m²)。盆腔和腹主动脉旁淋巴结的中位采集数量分别为 25.9(范围 3-63)和 10.6(范围 1-34)。LPL 和 LPAL 的中位手术时间分别为 72.3 分钟(范围 40-120 分钟)和 40 分钟(范围 20-70 分钟)。有 7 例发生大血管损伤,2 例发生淋巴漏,2 例发生淋巴水肿,2 例发生乳糜性腹水。无计划中转开腹。

结论

腹腔镜下淋巴结切除术是一种技术上可行且安全的手术方法,已成为妇科肿瘤学手术领域的替代方式。我们的结果可以加强现有的腹腔镜下淋巴结切除术相关数据。

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