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比较宫颈癌患者前哨淋巴结导航手术与盆腔淋巴结清扫术的淋巴并发症。

Comparison of lymphatic complications between sentinel node navigation surgery and pelvic lymphadenectomy in patients with cervical cancer.

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan.

出版信息

Jpn J Clin Oncol. 2020 May 5;50(5):543-547. doi: 10.1093/jjco/hyaa001.

Abstract

BACKGROUND

Sentinel node navigation surgery (SNNS) has been frequently used in early cervical cancer. However, the incidence and potential reduction of lymphatic complications following the removal of the sentinel lymph node remain unknown. Thus, this study aimed to evaluate the occurrence of lymphatic complications post sentinel node navigation surgery in patients with early cervical cancer.

METHODS

A total of 167 patients, including 70 and 97 patients who had undergone SNNS and pelvic lymphadenectomy (PLA), respectively, were enrolled in this study. We compared the lymphatic complications (lower extremity lymphedema and pelvic lymphocele) between the SNNS and PLA groups.

RESULTS

The median number of sentinel lymph nodes removed was 2 (range: 1-14). Among the 70 patients in the SNNS group, there were 0 (0%) and 3 (4.3%) occurrences of lower extremity lymphedema and pelvic lymphocele, respectively. The occurrences of lower extremity lymphedema and pelvic lymphocele were significantly lower in the SNNS group than in the PLA group, despite circumflex iliac node removal.

CONCLUSIONS

The occurrence of lymphatic complications (lower extremity lymphedema and pelvic lymphocele) was significantly lower in the SNNS group than in the PLA group. We found that SNNS, and not PLA, was the best treatment option for preventing the development of lower extremity lymphedema and pelvic lymphocele, despite circumflex iliac node preservation.

摘要

背景

前哨淋巴结导航手术(SNNS)已广泛应用于早期宫颈癌。然而,前哨淋巴结切除术后淋巴并发症的发生率及其潜在减少仍不清楚。因此,本研究旨在评估早期宫颈癌患者行前哨淋巴结导航手术后发生淋巴并发症的情况。

方法

本研究共纳入 167 例患者,其中 70 例行 SNNS,97 例行盆腔淋巴结清扫术(PLA)。我们比较了 SNNS 组和 PLA 组之间的淋巴并发症(下肢淋巴水肿和盆腔淋巴囊肿)。

结果

SNNS 组中,中位数为 2 枚(范围:1-14 枚)。70 例 SNNS 组中,下肢淋巴水肿和盆腔淋巴囊肿的发生率分别为 0(0%)和 3(4.3%)。尽管行旋髂淋巴结切除术,但 SNNS 组下肢淋巴水肿和盆腔淋巴囊肿的发生率明显低于 PLA 组。

结论

与 PLA 组相比,SNNS 组的淋巴并发症(下肢淋巴水肿和盆腔淋巴囊肿)发生率明显降低。我们发现,SNNS 是预防下肢淋巴水肿和盆腔淋巴囊肿发展的最佳治疗选择,即使保留旋髂淋巴结也是如此。

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