Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
Gynecological Oncology Department, Faculty of Medicine, Medipol University, Istanbul, Turkey.
J Obstet Gynaecol Res. 2024 Oct;50(10):1965-1970. doi: 10.1111/jog.16083. Epub 2024 Sep 12.
Sentinel lymph node dissection is performed in endometrial cancer surgery instead of staging surgery, particularly when the disease is advanced and confined to the uterus. The aim of this study is to share our sentinel lymph node detection rates via the vaginal natural orifice transluminal endoscopic surgery method with the literature and to demonstrate a safer and more comfortable surgical treatment process.
The analysis includes the patients who underwent surgery sentinel lymph node dissection for endometrial cancer utilizing indociyanin green in our center between January 2022 and June 2024.
In all, of 24 endometrial cancer patients underwent surgery sentinel lymph node dissection, nonendometrioid (serous) pathology was observed in only 1 (4%) patient, our other patients (96%) had endometrioid adenocarcinoma pathology. The rates of our sentinel lymph node dissection bilateral and symmetric are 96% (23/24), 94% (22/24), and 79% (19/24), respectively. We would like to emphasize that we successfully used vaginal natural orifice transluminal endoscopic surgery approach on four of our patients who were unsuitable for laparoscopic and robotic surgery due to pain scores of 2 at the 12th hour after surgery and low lung capacity.
Vaginal natural orifice transluminal endoscopic surgery and sentinel lymph node dissection will be considered as surgical options in other gynecological cancers due to the comfort it brings to the patient in endometrial cancer.
在子宫内膜癌手术中进行前哨淋巴结切除术，而不是分期手术，特别是当疾病进展且局限于子宫时。本研究旨在与文献分享我们通过阴道自然腔道内镜手术方法检测前哨淋巴结的检出率，并展示一种更安全、更舒适的手术治疗过程。
本分析包括 2022 年 1 月至 2024 年 6 月在我们中心接受吲哚菁绿引导下子宫内膜癌前哨淋巴结切除术的患者。
在 24 例接受手术前哨淋巴结切除术的子宫内膜癌患者中，仅 1 例（4%）患者为非子宫内膜样（浆液性）病理，我们的其他患者（96%）为子宫内膜样腺癌病理。我们的前哨淋巴结切除术双侧和对称的检出率分别为 96%（23/24）、94%（22/24）和 79%（19/24）。我们想强调的是，我们成功地在 4 名因术后 12 小时疼痛评分为 2 分和低肺容量而不适合腹腔镜和机器人手术的患者中使用了阴道自然腔道内镜手术方法。
由于阴道自然腔道内镜手术和前哨淋巴结切除术在子宫内膜癌中为患者带来的舒适度，它将被视为其他妇科癌症的手术选择。
