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接受腹腔镜单孔腹股沟淋巴结清扫术的外阴或阴道癌患者的长期预后。

Long-term outcomes of vulvar or vaginal cancer patients undergoing laparoendoscopic single-site inguinal lymphadenectomy.

作者信息

Xu Jing-Yun, Yu Tian-Xiang, Guan Xiao-Ming, Ding Bo, Ren Mu-Lan, Shen Yang

机构信息

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.

出版信息

J Minim Access Surg. 2024 Apr 1;20(2):180-186. doi: 10.4103/jmas.jmas_268_22. Epub 2023 Jul 5.

Abstract

INTRODUCTION

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.

PATIENTS AND METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

引言

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。

患者与方法

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。

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。

结论

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。

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