腔镜辅助小切口腹股沟淋巴结切除术治疗外阴癌

发布时间：2018-05-04 12:25

本文选题：腔镜辅助手术 + 小切口　；参考：《中国微创外科杂志》2017年03期

【摘要】：目的探讨腔镜辅助小切口(3 cm)腹股沟淋巴结切除术治疗外阴癌的可行性、安全性及临床效果。方法2013年9月~2015年12月,对6例外阴癌实施外阴局部广泛切除及腔镜辅助小切口腹股沟淋巴结切除术,其中单侧淋巴结清扫2例,双侧4例。腹股沟处做小切口(3 cm),提起皮肤边缘,逐渐分离皮下组织,暴露术野,在腔镜下行腹股沟淋巴结切除术。结果 6例均成功完成手术,未中转开腹手术,未出现术中副损伤。腹股沟淋巴结切除手术时间60~90(78.3±14.7)min,术中出血量20~40(31.6±9.8)ml。术后病理回报每侧切除淋巴结3~13(8.7±3.0)个。病理诊断均为外阴鳞状细胞癌。FIGO分期ⅠB期2例,Ⅱ期4例。术后切口拆线时间7~9(7.8±0.7)d。随访3~12(6.5±4.4)月,无术后切口裂开或延迟愈合、腹股沟区皮肤坏死、下肢淋巴水肿等手术并发症,未出现肿瘤复发和转移。结论外阴局部广泛切除联合腔镜辅助小切口腹股沟淋巴结切除术治疗外阴癌效果确切,安全可行,并发症少,恢复快,可保证手术根治性效果。
[Abstract]:Objective to explore the feasibility, safety and clinical effect of endoscopic assisted small incision (3 cm) inguinal lymph node resection for vulvar cancer. Methods in December September 2013, December, 6 cases of vulvar resection and endoscopic assisted inguinal lymph node resection were performed on 6 cases of vulvar carcinoma, including 2 cases of unilateral lymph node dissection, 4 cases of bilateral abdomen. A small incision (3 cm), the edge of the skin, the gradual separation of the subcutaneous tissue, the exposure field and the resection of the inguinal lymph nodes under the endoscopy. Results 6 cases were successfully completed, without transabdominal surgery, without secondary injury. The operation of inguinal lymph node resection was 60~90 (78.3 + 14.7) min, and the amount of bleeding during the operation was 20~40 (31.6 + 9.8) ml.. The pathological diagnosis was 3~13 (8.7 + 3) per side lymph node. The pathological diagnosis was 2 cases of.FIGO stage I B stage of vulvar squamous cell carcinoma and 4 cases in stage II. The postoperative incision disassembly time was 7~9 (7.8 + 0.7) d. for 3~12 (6.5 + 4.4) months, no postoperative incision or delayed healing, skin necrosis in the inguinal area, and lymphedema of lower extremities, and so on. Conclusion local extensive excision of vulva and endoscopic assisted small incision inguinal lymph node resection for vulvar cancer is effective, safe, feasible, less complications and quick recovery, which can guarantee radical effect of operation.

【作者单位】：首都医科大学附属北京安贞医院妇产科;首都医科大学附属北京安贞医院普外科;
【分类号】：R737.35

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