Department of Obstetrics and Gynecology, Zhongda Hospital, School of Medicine, Southeast University, No.87, Hu South Road, Nanjing, 210009, Jiangsu, People's Republic of China.
Minimally Invasive Gynecology Surgery, Baylor College of Medicine, Houston, TX, USA.
Arch Gynecol Obstet. 2020 Aug;302(2):497-503. doi: 10.1007/s00404-020-05649-5. Epub 2020 Jun 18.
Laparoendoscopic single-site surgery (LESS), a promising innovation in minimally invasive surgery, has been used in treating gynecologic oncology diseases. There have been no reports in the literature regarding LESS for inguinal lymphadenectomy (LESS-IL) in gynecologic conditions. We aimed to evaluate the feasibility, safety, and outcomes of LESS-IL.
Six patients with vulvar or vaginal cancer underwent LESS-IL from July 2018 to March 2019. Data regarding the intraoperative and postoperative outcomes were analyzed.
All patients successfully underwent a bilateral LESS-IL without conversion. LESS pelvic lymphadenectomy via an umbilical incision was also performed in a patient with vaginal cancer. The median operation time for the single-port laparoendoscopic inguinal lymphadenectomies was 105 min (range 70-134), with a median estimated blood loss of 108 ml (range 40-170). Median time of hospitalization was 7.5 days (range 5-10). A median of 11 (6-15) lymph nodes were dissected in a unilateral groin. The suction drains were removed after a median duration of 5 days (range 3-7). There were no skin-related or lymph-related postoperative complications. At a median follow-up period of 9 months, all the patients were alive and no recurrence was found.
LESS-IL is a feasible and safe technique for the surgical management of gynecologic cancers.
腹腔镜单部位手术（LESS）是微创外科的一项有前途的创新技术，已用于治疗妇科肿瘤疾病。在妇科疾病中，腹腔镜腹股沟淋巴结清扫术（LESS-IL）的应用尚未见文献报道。我们旨在评估 LESS-IL 的可行性、安全性和结果。
2018 年 7 月至 2019 年 3 月，6 例外阴或阴道癌患者接受 LESS-IL。分析了术中及术后结果的数据。
所有患者均成功完成双侧 LESS-IL，无中转开腹。1 例阴道癌患者还经脐部切口行 LESS 盆腔淋巴结清扫术。单孔腹腔镜腹股沟淋巴结清扫术的中位手术时间为 105 分钟（70-134 分钟），中位估计出血量为 108ml（40-170ml）。中位住院时间为 7.5 天（5-10 天）。单侧腹股沟区平均切除 11（6-15）枚淋巴结。引流管中位拔除时间为 5 天（3-7 天）。无皮肤相关或淋巴相关的术后并发症。中位随访 9 个月，所有患者均存活，未发现复发。
LESS-IL 是治疗妇科癌症的一种可行且安全的手术技术。
