Guidi Giacomo, Naldini Angelica, Garganese Giorgia, Fragomeni Simona Maria, Fagotti Anna, Bizzarri Nicoló
UOC Ginecologia Oncologica, Dipartimento di Scienze Della Salute Della Donna, Del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome.
Università Cattolica del Sacro Cuore, Rome, Italy.
Curr Opin Oncol. 2025 Sep 1;37(5):487-491. doi: 10.1097/CCO.0000000000001174. Epub 2025 Jul 22.
The evaluation of lymph node status is crucial for the correct staging of patients with vulvar carcinoma and to assess whether adjuvant treatment is necessary. Classically, this procedure is performed with an open approach to the inguinal region; however, this procedure is associated with a significant complication rate.For this reason, the video-endoscopic approach to inguinal lymph node assessment has been proposed in recent years. This review aimed to provide an overview on the feasibility and outcomes of the video-endoscopic inguinal lymphadenectomy (VEIL).
VEIL appeared to be a viable alternative to the open approach, with similar outcomes in terms of the number of lymph nodes removed and blood loss. While the postoperative complications rate was lower in the VEIL group, operative times tended to be longer. This may be due to the lack of standardization of the technique and to the variability in video-endoscopic approaches (laparoscopic vs robotic). Sentinel lymph node biopsy with endoscopic approach has also been described.
VEIL appears to be feasible and safe, adding benefits in terms of postoperative complications. Nevertheless, few studies are available and further data is needed to confirm these findings.
评估淋巴结状态对于外阴癌患者的准确分期以及判断是否需要辅助治疗至关重要。传统上，该操作通过对腹股沟区域采用开放手术进行；然而，此手术伴有较高的并发症发生率。因此，近年来有人提出采用视频内镜方法评估腹股沟淋巴结。本综述旨在概述视频内镜腹股沟淋巴结清扫术（VEIL）的可行性及结果。
VEIL似乎是开放手术的一种可行替代方法，在切除淋巴结数量和失血量方面结果相似。虽然VEIL组术后并发症发生率较低，但手术时间往往更长。这可能是由于该技术缺乏标准化以及视频内镜方法（腹腔镜与机器人手术）存在差异所致。也有关于内镜下前哨淋巴结活检的报道。
VEIL似乎可行且安全，在术后并发症方面有优势。然而，现有研究较少，需要更多数据来证实这些发现。
