Xu Jing-Yun, Yu Tian-Xiang, Guan Xiao-Ming, Ding Bo, Ren Mu-Lan, Shen Yang
Department of Obstetrics and Gynecology, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China.
Department of Obstetrics and Gynecology, School of Medicine, Southeast University, Nanjing, Jiangsu, China.
J Minim Access Surg. 2024 Apr 1;20(2):180-186. doi: 10.4103/jmas.jmas_268_22. Epub 2023 Jul 5.
Laparoendoscopic single-site inguinal lymphadenectomy (LESS-IL), a minimally invasive technique, has been reported in patients with vulvar or vaginal cancer regarding its safety and feasibility. However, the long-term outcomes, especially oncologic outcomes, are still lacking. We aimed to evaluate the long-term outcomes of LESS-IL to confirm its safety further.
Data were prospectively collected from patients with vulvar or vaginal cancer who underwent LESS-IL at our institution between July 2018 and June 2021. The patients were followed up for at least 12 months. All procedures were performed according to treatment standards. Short- and long-term complications and oncologic outcomes were analysed.
A total of 16 patients undergoing 28 LESS-IL procedures were identified, amongst whom 4 underwent unilateral LESS-IL. The median numbers of excised groin lymph nodes were 9.0 (6.5-11.8) and 10.5 (8.3-12.0) in each left and right groin, respectively. Short-term complications occurred in 4 (25%) patients, including 18.7% lymphocele and 6.3% wound infection. Long-term complications regarding lower-limb lymphoedema appeared in 6 (37.5%) patients. Most short- and long-term complications were Clavien-Dindo 1 or 2, accounting for 90% of all post-operative issues. After a median follow-up of 27 (21.3-35.8) months, only 1 (6.3%) patient had isolated inguinal recurrence at 13 months postoperatively. No local or distant recurrence occurred.
Our results suggest that LESS-IL is associated with little incidence of complications and promising oncologic outcomes, further demonstrating the safety and feasibility of the LESS-IL technique in patients requiring IL.
腹腔镜单孔腹股沟淋巴结清扫术(LESS-IL)是一种微创技术,已在患有外阴癌或阴道癌的患者中报道了其安全性和可行性。然而,其长期结果,尤其是肿瘤学结果,仍然缺乏。我们旨在评估LESS-IL的长期结果以进一步确认其安全性。
前瞻性收集2018年7月至2021年6月期间在我院接受LESS-IL的外阴癌或阴道癌患者的数据。对患者进行至少12个月的随访。所有手术均按照治疗标准进行。分析短期和长期并发症以及肿瘤学结果。
共确定16例患者接受了28次LESS-IL手术,其中4例接受单侧LESS-IL。左右腹股沟切除的腹股沟淋巴结中位数分别为9.0(6.5-11.8)和10.5(8.3-12.0)。4例(25%)患者发生短期并发症,包括18.7%的淋巴囊肿和6.3%的伤口感染。6例(37.5%)患者出现下肢淋巴水肿的长期并发症。大多数短期和长期并发症为Clavien-Dindo 1或2级,占所有术后问题的90%。中位随访27(21.3-35.8)个月后,仅1例(6.3%)患者在术后13个月出现孤立性腹股沟复发。未发生局部或远处复发。
我们的结果表明,LESS-IL并发症发生率低且肿瘤学结果良好,进一步证明了LESS-IL技术在需要腹股沟淋巴结清扫术的患者中的安全性和可行性。