Manahan K J, Hudec J, Fanning J
Division of Gynecologic Oncology, Medical College of Ohio, Toledo, Ohio 43614, USA.
Gynecol Oncol. 1997 Nov;67(2):166-7. doi: 10.1006/gyno.1997.4866.
Our objective was to review our experience with vulvar cancer treated with modified radical vulvectomy without lymphadenectomy under local anesthesia and sedation.
A retrospective review of surgical case lists revealed five patients who underwent modified radical vulvectomy without lymphadenectomy under local anesthesia with sedation. All patients had significant medical diseases which precluded regional or general anesthesia. Modified radical vulvectomy was performed in standard fashion under sedation and local anesthesia. Inguinal lymphadenectomy was not performed.
Median operative time was 1.5 h and median blood loss was 100 cc. Median diameter of tissue resected was 5 cm and median depth was 5 cm. Median length of hospital stay was 4 days. No patient complained of pain during the operative procedure. At a median follow-up of 2.5 years, there has been one local recurrence.
Five patients with symptomatic vulvar cancer who were not candidates for regional or general anesthesia underwent modified radical vulvectomy without lymphadenectomy under local anesthesia with sedation. The procedure was well-tolerated and produced minimal morbidity and adequate short-term local control.
我们的目的是回顾我们在局部麻醉和镇静下进行改良根治性外阴切除术且不进行淋巴结清扫术治疗外阴癌的经验。
对手术病例清单进行回顾性分析，发现有5例患者在局部麻醉加镇静的情况下接受了改良根治性外阴切除术且未进行淋巴结清扫术。所有患者均患有严重的内科疾病，无法进行区域麻醉或全身麻醉。改良根治性外阴切除术在镇静和局部麻醉下以标准方式进行。未进行腹股沟淋巴结清扫术。
中位手术时间为1.5小时，中位失血量为100毫升。切除组织的中位直径为5厘米，中位深度为5厘米。中位住院时间为4天。术中无患者抱怨疼痛。中位随访2.5年时，有1例局部复发。
5例有症状的外阴癌患者因不适合进行区域麻醉或全身麻醉，在局部麻醉加镇静的情况下接受了改良根治性外阴切除术且未进行淋巴结清扫术。该手术耐受性良好，发病率极低，短期局部控制效果良好。
