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经外阴切口免气腹单孔腹腔镜腹股沟淋巴结清扫术治疗外阴癌的短期疗效分析

Analysis of Short-Term Efficacy of Gasless Single-Port Laparoscopic Inguinal Lymphadenectomy Through Vulva Incision for Vulvar Cancer.

作者信息

Ding Jin, Teng Piaopiao, Guan Xiaoming, Luo Yonghong, Ding Huafeng, Shi Suhua, Zhou Xiufen, Ni Guantai

机构信息

Department of Obstetrics and Gynecology, First Affiliated Hospital of Wannan Medical College, Wuhu, China.

Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States.

出版信息

Front Surg. 2022 Mar 24;9:813711. doi: 10.3389/fsurg.2022.813711. eCollection 2022.

Abstract

OBJECTIVE

To investigate the feasibility and short-term efficacy of gasless single-port laparoscopic inguinal lymphadenectomy through vulva incision (VEIL-V).

METHODS

The data of 9 patients diagnosed as vulvar squamous cell carcinoma who underwent single-port laparoscopic inguinal lymph node dissection through vulvectomy incision were retrospectively analyzed. And 13 patients who underwent laparoscopic inguinal lymph node dissection through lower abdominal subcutaneous approach as the control group (VEIL-H). The operation time, blood loss, numbers of unilateral lymph nodes, hospitalization time, and complications between the two groups were compared.

RESULTS

The operation time of VEIL-V was 56.11 ± 5.94 min, which were shorter than that of VEIL-H (74.62 ± 5.50 min; = 0.013). Bleeding amount in the VEIL-H was 29.44 ± 2.56, which was significantly lower than that of the VEIL-H group (43.08 ± 4.14 ml; = 0.021). In the two groups, the numbers of unilateral lymph nodes harvested were similar. The differences in the postoperative hospital stay, skin, and lymphatic complications were not statistically significant.

CONCLUSION

Compared with VEIL-H, gasless single-port laparoscopic inguinal lymphadenectomy through vulva incision reduces the difficulty of operation with shorter operation time, and less blood loss, which can be a safe and mini-invasive surgical approach.

摘要

目的

探讨经外阴切口无气腹单孔腹腔镜腹股沟淋巴结清扫术(VEIL-V)的可行性及短期疗效。

方法

回顾性分析9例经外阴切除术切口行单孔腹腔镜腹股沟淋巴结清扫术的外阴鳞状细胞癌患者的数据。选取13例经下腹部皮下入路行腹腔镜腹股沟淋巴结清扫术的患者作为对照组(VEIL-H)。比较两组的手术时间、出血量、单侧淋巴结数量、住院时间及并发症情况。

结果

VEIL-V组手术时间为56.11±5.94分钟,短于VEIL-H组(74.62±5.50分钟;P=0.013)。VEIL-V组出血量为29.44±2.56,显著低于VEIL-H组(43.08±4.14毫升;P=0.021)。两组单侧淋巴结清扫数量相近。术后住院时间、皮肤及淋巴并发症差异无统计学意义。

结论

与VEIL-H相比,经外阴切口无气腹单孔腹腔镜腹股沟淋巴结清扫术降低了手术难度,手术时间更短,出血量更少,是一种安全、微创的手术方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e758/8987365/5679c2358a6f/fsurg-09-813711-g0001.jpg

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