Tanaka Tomohito, Terai Yoshito, Ono Yoshihiro J, Fujiwara Satoe, Tanaka Yoshimichi, Sasaki Hiroshi, Tsunetoh Satoshi, Kanemura Masanori, Ohmichi Masahide
Department of Obstetrics and Gynecology, Osaka Medical College, Takatsuki, Japan.
Int J Gynecol Cancer. 2015 Mar;25(3):533-6. doi: 10.1097/IGC.0000000000000335.
The aim of this study was to estimate the incidence, etiology, and outcomes of genitofemoral neuropathy after pelvic lymphadenectomy (PLD) for uterine corpus cancer.
The medical records of women who underwent PLD for uterine corpus cancer between June 2001 and June 2013 were reviewed. Information regarding neuropathy was directly reported by each subject.
Thirty-two of 300 patients undergoing PLD during the defined period experienced postoperative neuropathy due to genitofemoral nerve injury, for an incidence of 10.7%. The patients treated with PLD with para-aortic lymphadenectomy (PALD) exhibited a lower rate of genitofemoral neuropathy than those treated without PALD (4.3% vs 13.5%, P = 0.01). The laparoscopy group displayed a higher rate of genitofemoral neuropathy than the laparotomy group (19.1% vs 9.1%, P = 0.04). A total of 81.3% of the patients experienced a full recovery, with a medium time to resolution of 6 months (3-12 months). The administration of adjuvant chemotherapy, including paclitaxel, did not extend the time to recovery.
Neuropathy resulting from genitofemoral nerve injury is not infrequent; however, most of the patients recover completely. In this study, the use of laparoscopic procedures increased the incidence of genitofemoral neuropathy, whereas that of PALD did not.
本研究旨在评估子宫体癌盆腔淋巴结清扫术(PLD)后股神经生殖支神经病变的发生率、病因及预后。
回顾了2001年6月至2013年6月期间因子宫体癌接受PLD的女性患者的病历。每位受试者直接报告有关神经病变的信息。
在规定期间接受PLD的300例患者中,有32例因股神经生殖支神经损伤出现术后神经病变,发生率为10.7%。接受PLD联合主动脉旁淋巴结清扫术(PALD)治疗的患者股神经生殖支神经病变发生率低于未接受PALD治疗的患者(4.3%对13.5%,P = 0.01)。腹腔镜组股神经生殖支神经病变发生率高于剖腹手术组(19.1%对9.1%,P = 0.04)。共有81.3%的患者完全康复,恢复的中位时间为6个月(3 - 12个月)。包括紫杉醇在内的辅助化疗并未延长恢复时间。
股神经生殖支神经损伤导致的神经病变并不少见;然而,大多数患者可完全康复。在本研究中,腹腔镜手术的使用增加了股神经生殖支神经病变的发生率,而PALD则未增加。