改良腹股沟淋巴结清扫术在外阴癌中的应用(附20例报道)

摘要

Objective To investigate the application of modified inguinal lymphadenectomy in vulva cancer.Methods 20 patients with vulva cancer underwent bilateral modified inguinal lymphadenectomy and radical vulvectomy.Survival and complication data were retrospectively analyzed.Results The average number of superficial lymph nodes was 13.2 (10-19) per side,while that of deep lymph nodes was 2.1 (1-4) per side.Complications included skin necrosis (7.5％) and lymphedema (20％).The average follow up period was 34.2 months (14-86 months).Disease free survival rate was 80.8％,and that for N0,N1,and N2 were 100％,80％,0％ respectively.Conclusion Modified inguinal lymphadenectomy has good operation result and few complications,worthy of clinical promotion.%目的 探讨改良腹股沟淋巴结清扫术在外阴癌治疗中的应用,为治疗外阴癌提供新的方法.方法 对20例外阴癌患者行广泛性外阴切除+双侧改良腹股沟淋巴结清扫术,并对患者的病理结果、术后并发症及随访结果进行观察.结果 平均每侧浅组清扫淋巴结13.2枚(10～ 19枚),股沟淋巴结2.1枚(1～4枚).术后早期主要并发症为皮瓣皮缘坏死,2侧轻度,1侧中度,淋巴瘘及淋巴囊肿未见.远期常见并发症为双下肢水肿,共4例(15.4％),均为轻度.20例患者平均随访时间为34.2月(14～86月),总体无瘤生存率为80.8％,其中N0为100％(17/17),N1为80％(4/5),N2为0(0/4).结论 改良腹股沟淋巴结清扫术手术效果好、并发症少,推广应用有助于提高外阴癌的疗效.