早期子宫内膜癌盆腔及腹主动脉旁淋巴结清扫术的作用

摘要

There is no agreement about the range and model of surgical treatment in endometrial carcinoma, especially for the necessity of systematic pelvic and para-aortic lymphadenectomy. The sentinel lymph node selectively excision can be preceded in low risk early-stage endometrial carcinoma. But in high risk group, retroperitoneal lvmph node dissection can not replace the systematic and complete pelvic and para-aortic lymphadenectomy which does not increase the risk for major organ damage, second surgery and severe intestinal obstruction. Systematic and complete pelvic and para-aortic lymphadenectomy can improve the survival and prognosis.%关于子宫内膜癌的手术范围和模式至今尚无统一的意见,尤其是对系统性盆腔及腹主动脉旁淋巴结清扫的必要性和清扫范围仍然存在较大争议.早期低危子宫内膜癌可以通过前哨淋巴结检测进行局部淋巴结选择性切除,从而降低手术风险.但在中-高危子宫内膜癌患者中,腹膜后淋巴结活检不能代替系统性盆腔及腹主动脉旁淋巴结清扫.腹主动脉旁淋巴结清扫术不会增加重大脏器损伤、二次手术及重度肠梗阻的风险.系统性盆腔及腹主动脉旁淋巴结清扫可以提高子宫内膜癌患者的生存率并改善预后.