Naldini Angelica, Rossitto Cristiano, Pacelli Fabio, Vizzielli Giuseppe, Campagna Giuseppe, Moruzzi Maria Cristina, Scambia Giovanni
Division of Gynecologic Oncology, Department of Women's and Children's Health, "Agostino Gemelli" Foundation University Hospital, Rome, Italy.
Division of Gynecologic Oncology, Department of Women's and Children's Health, "Agostino Gemelli" Foundation University Hospital, Rome, Italy.
Taiwan J Obstet Gynecol. 2017 Jun;56(3):281-285. doi: 10.1016/j.tjog.2017.04.003.
This prospective pilot study aims to validate feasibility, efficacy and safeness of the innovative technique of video endoscopy inguinal lymphadenectomy (VEIL) and compare it to open inguinal lymphadenectomy (OIL) in the staging and treatment of vulvar cancer (VC).
All patients affected by VC suitable for bilateral inguinal-femoral lymphadenectomy were prospectively enrolled and submitted to VEIL on one side and OIL contralaterally, sparing the saphenous vein. The surgical and post-surgical data were collected. Univariate analysis included chi square analysis or Fisher's exact test, when appropriate for categorical variables, and the Student t test and Mann-Whitney test when appropriate for continuous variables.
Between October 2014 and June 2015 fifteen patients were valuable for the study. Although nodal retrieval was comparable for both procedures, operative time was higher after VEIL. No intraoperative complications were observed in both techniques. Postoperative complications were observed in 3 and 2 cases for OIL and VEIL respectively. One patient needed reoperation after OIL for wound necrosis and infection. According to Campisi's stage, lymphedema resulted significantly to be lower after VEIL (p = 0.024).
Waiting for larger series and longer follow-up data, the VEIL seems to be feasible allowing a radical removal of inguinal lymph nodes as well as OIL with lower morbidity.
本前瞻性试点研究旨在验证视频内镜腹股沟淋巴结清扫术（VEIL）这一创新技术的可行性、有效性和安全性，并将其与开放腹股沟淋巴结清扫术（OIL）在外阴癌（VC）的分期和治疗方面进行比较。
所有适合双侧腹股沟 - 股淋巴结清扫术的VC患者均被前瞻性纳入研究，一侧接受VEIL，对侧接受OIL，保留大隐静脉。收集手术及术后数据。单因素分析在适用于分类变量时采用卡方分析或Fisher精确检验，在适用于连续变量时采用Student t检验和Mann - Whitney检验。
2014年10月至2015年6月期间，15例患者对本研究有价值。虽然两种手术方式的淋巴结获取情况相当，但VEIL术后手术时间更长。两种技术均未观察到术中并发症。OIL和VEIL术后分别有3例和2例出现术后并发症。1例患者在OIL术后因伤口坏死和感染需要再次手术。根据坎皮西分期，VEIL术后淋巴水肿明显较低（p = 0.024）。
在等待更大样本量和更长随访数据的过程中，VEIL似乎是可行的，能够像OIL一样彻底清除腹股沟淋巴结，且发病率更低。
