Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Minim Invasive Gynecol. 2012 Mar-Apr;19(2):188-95. doi: 10.1016/j.jmig.2011.10.013. Epub 2011 Dec 15.
To assess the feasibility and efficacy of laparoscopic lymphadenectomy in patients with isolated lymph node recurrences (ILNR) who underwent initial surgery because of gynecologic malignancy.
Retrospective study (Canadian Task Force classification II-3).
University teaching hospital.
Six patients with ILNR (1 cervical, 4 ovarian, and 1 peritoneal) diagnosed between March 2003 and July 2010.
Laparoscopic lymphadenectomy.
Median (range) patient age was 59.5 (24-70) years, and body mass index was 21.7 (21.0-24.6). There was no unplanned conversion to laparotomy. Operating time was 337.5 (200-400) minutes, hemoglobin change was 0.9 (0.4-2.6) g/dL, and hospital stay was 8.5 (5-19) days. The number of harvested lymph nodes was 20 (5-27), and of positive lymph nodes was 4 (1-24). One patient had common iliac vein laceration, with complete hemostasis achieved using intracorporeal suture. Postoperative lymphedema occurred in 1 patient, and was managed conservatively. All patients received adjuvant chemotherapy after laparoscopic lymphadenectomy.
Laparoscopic lymphadenectomy in patients with ILNR is feasible and might be an alternative therapeutic strategy.
评估对因妇科恶性肿瘤接受初始手术且发生孤立淋巴结复发（ILNR）的患者施行腹腔镜下淋巴结切除术的可行性和疗效。
回顾性研究（加拿大卫生保健研究协会分类 II-3 级）。
大学教学医院。
2003 年 3 月至 2010 年 7 月期间诊断为 ILNR 的 6 例患者（1 例宫颈，4 例卵巢，1 例腹膜）。
腹腔镜下淋巴结切除术。
中位（范围）患者年龄为 59.5（24-70）岁，体重指数为 21.7（21.0-24.6）。无一例计划外中转开腹。手术时间为 337.5（200-400）分钟，血红蛋白变化为 0.9（0.4-2.6）g/dL，住院时间为 8.5（5-19）天。采集的淋巴结数量为 20（5-27）枚，阳性淋巴结数量为 4（1-24）枚。1 例患者出现髂总静脉裂伤，采用腔内缝合实现完全止血。1 例患者术后发生淋巴水肿，采用保守治疗。所有患者在腹腔镜下淋巴结切除术后均接受辅助化疗。
对 ILNR 患者施行腹腔镜下淋巴结切除术是可行的，可能是一种替代的治疗策略。
