Sana Klinikum Remscheid, Burger Str. 211, Remscheid D-42859, Germany.
Kaiserswerther Diakonie, Florence Nightingale Hospital, Kreuzbergstraße 79, Dusseldorf D-40489, Germany.
Eur J Surg Oncol. 2015 Jan;41(1):40-5. doi: 10.1016/j.ejso.2014.10.050. Epub 2014 Oct 31.
Vulvar carcinomas are rare genital malignancies. In a retrospective study on 21 patients factors influencing the quality of life and sexual function were investigated. All patients were interviewed according to the Female Sexual Function Index questionnaire (FSFI) and the Short Form 12(®) questionnaire (SF12).
We identified 21 patients that had been operated for vulvar carcinoma FIGO stage I or IIIa in the years 2006-2008. Patients that had adjuvant radiotherapy were excluded. 14 patients had been treated by a wide excision, the other 7 by a vulvectomy. 10 patients had undergone a total inguinal lymphadenectomy, 5 patients a sentinel node biopsy. In a multivariate analysis lymphadenectomy was the only factor influencing the patients' sexual function: Patients without lymphadenectomy or with sentinel node biopsy scored better in terms of sexual function, neither age nor the extend of the surgery resulted in a significant difference.
The lymphadenectomy has a negative influence on the patients' sexual function after surgical treatment for vulvar carcinoma. The indication for lymphadenectomy should hence be seen critically.
外阴癌是一种罕见的生殖系统恶性肿瘤。本研究回顾性分析了 21 例外阴癌患者，旨在探讨影响患者生活质量和性功能的因素。所有患者均接受女性性功能指数问卷（FSFI）和健康调查简表 12 项（SF12）问卷调查。
2006 年至 2008 年间，我们共纳入了 21 例行外阴癌FIGO Ⅰ期或Ⅲa 期手术的患者，其中有 14 例行广泛切除术，7 例行外阴切除术，10 例行腹股沟淋巴结清扫术，5 例行前哨淋巴结活检术。多因素分析显示，淋巴结清扫术是影响患者性功能的唯一因素：未行淋巴结清扫或行前哨淋巴结活检的患者，其性功能评分更好，而年龄和手术范围与性功能无显著相关性。
对于行手术治疗的外阴癌患者，淋巴结清扫术会对其性功能产生负面影响。因此，淋巴结清扫术的适应证应严格掌握。
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