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根治性外阴切除术中缝匠肌腱转位的临床应用:单机构58例病例对照研究

Clinical application of sartorius tendon transposition during radical vulvectomy: a case control study of 58 cases at a single institution.

作者信息

Li Lei, Kou Xinxin, Feng Xiaojie, Liu Fenghua, Chao Hongtu, Wang Liying

机构信息

Department of Gynecologic Oncology, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

J Gynecol Oncol. 2015 Oct;26(4):320-6. doi: 10.3802/jgo.2015.26.4.320. Epub 2015 Sep 23.

Abstract

OBJECTIVE

The aim of this study was to investigate the clinical effects of sartorius tendon transposition versus sartorius transposition during bilateral inguinal lymphadenectomy of radical vulvectomy.

METHODS

A total of 58 vulvar cancer patients who had surgery from May 2007 to October 2013, in which 30 patients received sartorius transposition and 28 patients received sartorius tendon transposition. All patients were matched by age, body mass index, stage, histology, and grade. Intraoperative variables and postoperative complications, recurrence, progression-free survival (PFS), and overall survival (OS) and postoperative life quality were compared and analyzed.

RESULTS

No significant differences were found at median surgical times and amounts of bleeding (p=0.316 and p=0.249, respectively), neither at the incidences of groin cellulitis and lymphocele (p=0.673 and p=0.473, respectively), but the recovery times of the inguinal wounds were shorter (p=0.026) and the incidences of wound break and chronic lymphedema were significantly decreased in the tendon transposition group (p=0.012 and p=0.022, respectively). Postoperative quality of life in tendon transposition group was significantly improved as indicated by the EORTC QLQ-C30 questionnaire. Recurrences were similar (p=0.346) and no significant differences were found at PFS and OS (p=0.990 and p=0.683, respectively).

CONCLUSION

Compared to sartorius transposition, sartorius tendon transposition during inguinal lymphadenectomy led to improved patient recovery, reduced postoperative complications, and improved life quality without compromising the outcomes.

摘要

目的

本研究旨在探讨在根治性外阴切除术双侧腹股沟淋巴结清扫术中,缝匠肌移位术与缝匠肌腱移位术的临床效果。

方法

选取2007年5月至2013年10月期间接受手术的58例外阴癌患者,其中30例接受缝匠肌移位术,28例接受缝匠肌腱移位术。所有患者均根据年龄、体重指数、分期、组织学类型和分级进行匹配。比较并分析术中变量、术后并发症、复发情况、无进展生存期(PFS)、总生存期(OS)以及术后生活质量。

结果

中位手术时间和出血量方面未发现显著差异(分别为p = 0.316和p = 0.249),腹股沟蜂窝织炎和淋巴囊肿的发生率也无显著差异(分别为p = 0.673和p = 0.473),但肌腱移位组腹股沟伤口的恢复时间更短(p = 0.026),伤口裂开和慢性淋巴水肿的发生率显著降低(分别为p = 0.012和p = 0.022)。欧洲癌症研究与治疗组织(EORTC)QLQ - C30问卷显示,肌腱移位组术后生活质量显著改善。复发情况相似(p = 0.346),PFS和OS方面也未发现显著差异(分别为p = 0.990和p = 0.683)。

结论

与缝匠肌移位术相比,腹股沟淋巴结清扫术中的缝匠肌腱移位术可促进患者恢复,减少术后并发症,提高生活质量,且不影响治疗效果。

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