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经三切口外侧入路的视频内镜下腹股沟淋巴结清扫术治疗外阴癌:37例患者的初步结果

Video Endoscopic Inguinal Lymphadenectomy via 3-Incision Lateral Approach for Vulvar Cancers: Our Preliminary Outcome of 37 Cases.

作者信息

Wu Qiang, Gong Zhen, Zhao Yibing, Sun Zhihua, Shao Henghua, Dai Zhiqin, Qu Junwei, Xu Hanzi

机构信息

*Department of Gynecological Oncology, Jiangsu Cancer Hospital; †Department of Gynecology, Nanjing Maternity and Child Health Care Hospital; and ‡Department of Radiation Oncology, Jiangsu Cancer Hospital, Nanjing Medical University, Nanjing, People's Republic of China.

出版信息

Int J Gynecol Cancer. 2016 Nov;26(9):1706-1711. doi: 10.1097/IGC.0000000000000816.

Abstract

OBJECTIVE

The purpose of this study was to build a video endoscopic inguinal lymphadenectomy (VEIL) via the 3-incision superolateral inguinal approach and explore the feasibility and significance of this method for vulvar cancer.

METHODS

Thirty-seven patients with vulvar cancer who underwent VEIL via the 3-incision superolateral inguinal approach were enrolled and followed up. The number of excised lymph nodes, intraoperative complications, inguinal wound healing, and the prognosis were retrospectively analyzed.

RESULTS

The average number of excised lymph nodes per side is 8.8 ± 3.7 (4-18) among the 37 patients and after the new method was more mature, is 9.6 ± 3.6 among the 34 patients treated. Primary healing was found in 36 cases, whereas delayed healing occurred in 1 case complicated with diabetes. The lymph node-positive patients (6 cases) were supplemented with postoperative radiochemotherapy (RCT). All patients survived during the follow-up. Of the 2 recurrent patients, one patient who received surgery again and RCT survived without tumor. The other patient undergoing RCT survived with tumor.

CONCLUSIONS

Compared with open lymphadenectomy, VEIL via the 3-incision lateral approach provides a feasible, but more cosmetic, and promising minimally invasive modality in clinic for treating patients with vulvar cancer.

摘要

目的

本研究旨在通过三切口腹股沟上外侧入路构建视频内镜腹股沟淋巴结清扫术(VEIL),并探讨该方法对外阴癌的可行性和意义。

方法

纳入37例行三切口腹股沟上外侧入路VEIL的外阴癌患者并进行随访。回顾性分析切除淋巴结数量、术中并发症、腹股沟伤口愈合情况及预后。

结果

37例患者每侧平均切除淋巴结数为8.8±3.7(4 - 18个),新方法成熟后,34例接受治疗患者每侧平均切除淋巴结数为9.6±3.6个。36例一期愈合,1例合并糖尿病患者延迟愈合。淋巴结阳性患者(6例)术后补充放化疗(RCT)。所有患者随访期间均存活。2例复发患者中,1例再次手术并接受RCT后无瘤存活。另1例接受RCT患者带瘤存活。

结论

与开放淋巴结清扫术相比,三切口外侧入路VEIL为临床治疗外阴癌患者提供了一种可行、更具美容效果且有前景的微创方式。

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