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经大腿入路的内镜腹股沟淋巴结清扫术治疗妇科恶性肿瘤:一项具有5年经验的回顾性研究

Endoscopic groin lymphadenectomy with a thigh approach to gynecologic malignancies: a retrospective study with 5-year experience.

作者信息

Li Menghui, Wang Shuzhen, Guo Shuli, Zhang Zhenyu

机构信息

Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital University of Medical Science, Beijing, China.

出版信息

Int J Gynecol Cancer. 2015 Feb;25(2):325-30. doi: 10.1097/IGC.0000000000000348.

Abstract

OBJECTIVES

The objective of this study was to report a safe and feasible technique with endoscopic groin lymphadenectomy (EGL) through thigh approach in the treatment of different gynecologic malignancies.

STUDY DESIGN

Consecutive gynecological malignant patients proceeded to groin lymphadenectomy were treated by this technique over a 5-year period (2005 to 2010). Data regarding the surgical perioperative complications were recorded.

RESULTS

Eleven patients with 21 EGL were performed. Procedures included bilateral groin lymphadenectomy (n = 10) and left groin lymphadenectomy (n = 1). The median patient age and body mass index were 61 years and 25.2, respectively. The median operational time, which includes the dissection of both groins and the other procedures, was 210 minutes. The median blood loss was 200 mL. The median number of retrieved lymph nodes was 13 (range, 8-26), and all of these are histologically negative. No intraoperative complications occurred. One patient was noted in cutaneous cellulitis on the right side of the patient with clinical resolution 15 days after surgery. There were no perioperative mortalities. All the cutaneous scars were healed without wound breakdown. There were no perioperative mortalities. At the latest follow-up, all patients were completely satisfied with the cosmetic results.

CONCLUSIONS

In this study, we first report EGL with a thigh approach in gynecologic malignancies; it is a safe and feasible technique, for groin nodal dissection, with low risks of morbidity of the skin and legs. A larger prospective study with long-term and survival analyses is warranted.

摘要

目的

本研究的目的是报告一种通过大腿入路进行内镜腹股沟淋巴结清扫术(EGL)治疗不同妇科恶性肿瘤的安全可行技术。

研究设计

在5年期间(2005年至2010年),采用该技术对连续进行腹股沟淋巴结清扫术的妇科恶性肿瘤患者进行治疗。记录手术围手术期并发症的数据。

结果

共对11例患者进行了21次EGL手术。手术包括双侧腹股沟淋巴结清扫术(n = 10)和左侧腹股沟淋巴结清扫术(n = 1)。患者的中位年龄和体重指数分别为61岁和25.2。包括双侧腹股沟解剖和其他手术的中位手术时间为210分钟。中位失血量为200 mL。中位回收淋巴结数为13个(范围8 - 26个),所有这些淋巴结组织学检查均为阴性。术中无并发症发生。1例患者术后第15天右侧出现皮肤蜂窝织炎,临床症状缓解。无围手术期死亡病例。所有皮肤瘢痕均愈合,无伤口裂开。无围手术期死亡病例。在最近一次随访时,所有患者对美容效果均完全满意。

结论

在本研究中,我们首次报告了在妇科恶性肿瘤中采用大腿入路的EGL;这是一种安全可行的腹股沟淋巴结清扫技术,皮肤和腿部并发症风险低。有必要进行一项更大规模的前瞻性研究,并进行长期和生存分析。

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