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超越前哨淋巴结:吲哚菁绿引导的盆腔淋巴结切除术在子宫内膜癌和宫颈癌中的应用。

Beyond Sentinel Lymph Node: Outcomes of Indocyanine Green-Guided Pelvic Lymphadenectomy in Endometrial and Cervical Cancer.

机构信息

Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS "Regina Elena" National Cancer Institute, 00144 Rome, Italy.

Unit of Gynecologic Oncology, ARNAS "Civico-Di Cristina-Benfratelli", Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy.

出版信息

Int J Environ Res Public Health. 2023 Feb 16;20(4):3476. doi: 10.3390/ijerph20043476.

Abstract

BACKGROUND

The aim of our study was to compare the number of lymph nodes removed during indocyanine green (ICG)-guided laparoscopic/robotic pelvic lymphadenectomy with standard systematic lymphadenectomy in endometrial cancer (EC) and cervical cancer (CC).

METHODS

This is a multicenter retrospective comparative study (Clinical Trial ID: NCT04246580; updated on 31 January 2023). Women affected by EC and CC who underwent laparoscopic/robotic systematic pelvic lymphadenectomy, with (cases) or without (controls) the use of ICG tracer injection within the uterine cervix, were included in the study.

RESULTS

The two groups were homogeneous for age ( = 0.08), Body Mass Index, International Federation of Gynaecology and Obstetrics (FIGO) stages ( = 0.41 for EC; = 0.17 for CC), median estimated blood loss ( = 0.76), median operative time ( = 0.59), and perioperative complications ( = 0.66). Nevertheless, the number of lymph nodes retrieved during surgery was significantly higher ( = 0.005) in the ICG group ( = 18) compared with controls ( = 16).

CONCLUSIONS

The accurate and precise dissection achieved with the use of the ICG-guided procedure was associated with a higher number of lymph nodes removed in the case of systematic pelvic lymphadenectomy for EC and CC.

摘要

背景

本研究旨在比较吲哚菁绿(ICG)引导的腹腔镜/机器人盆腔淋巴结切除术与子宫内膜癌(EC)和宫颈癌(CC)标准系统淋巴结切除术的淋巴结切除数量。

方法

这是一项多中心回顾性比较研究(临床试验 ID:NCT04246580;更新于 2023 年 1 月 31 日)。纳入接受腹腔镜/机器人系统盆腔淋巴结切除术的 EC 和 CC 患者,包括(病例组)或不包括(对照组)宫颈内注射 ICG 示踪剂。

结果

两组患者的年龄( = 0.08)、体重指数、国际妇产科联合会(FIGO)分期(EC 为 = 0.41;CC 为 = 0.17)、估计出血量中位数( = 0.76)、手术时间中位数( = 0.59)和围手术期并发症( = 0.66)均相似。然而,ICG 组( = 18)的手术中淋巴结切除数量明显多于对照组( = 16)( = 0.005)。

结论

在 EC 和 CC 的系统盆腔淋巴结切除术时,使用 ICG 引导的精确和准确的解剖与更多的淋巴结切除数量相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea22/9963568/a8857a54deef/ijerph-20-03476-g001.jpg

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