腹腔镜下腹股沟淋巴结切除术治疗外阴癌的临床研究

目的　探讨外阴浸润癌行腹腔镜下腹股沟淋巴结切除术的可行性和手术技巧。方法　２０１０年１１月至２０１１年８月对１０例外阴癌患者行根治性局部外阴切除术和腹腔镜下腹股沟淋巴结切除术，必要时行盆腔淋巴结切除术。结果　１０例患者均在腹腔镜下腹股沟淋巴结切除术后行根治性局部外阴切除。平均每侧腹股沟淋巴结切除手术时间为９１ｍｉｎ（８０～１３０ｍｉｎ），术中每侧腹股沟淋巴结切除平均出血为６.３ｍｌ（５～１０ｍｌ），切除淋巴结数平均为７.４个（单侧），淋巴结转移２例，平均拔管时间为６.８ｄ（５～１０ｄ），所有患者均未发生腹股沟区皮肤坏死。结论　外阴广泛切除联合腹腔镜下腹股沟淋巴结切除术治疗外阴浸润癌安全、可靠，手术创伤小，术后切口愈合佳，不易发生腹股沟区皮肤缺血坏死。

Clinical study on laparoscopic inguinal lymphadenectomy for vulvar carcinoma

Objective To investigate the feasibility and skill of laparoseopic excision of inguinal lymph nodes for vulvar carcinoma.Methods Ten cases with vulvar cancer who underwent wide resection of vulva and laparoseopic exeision of inguinal lymph nodes and pelvic lymphadenectomy as necessary from November 2010 to August 2011 were reviewed.Results Lymphadenectomies,including superficial and deep inguinal node dissection,were completed in ten patients successfully.The mean operative time was 91min（range 80-130min）,the average bleed of each side inguinal lymph node dissection was 6.3 ml（5-10ml）,and the mean number of nodes removed from unilateral inguinal region was 7.4.No perioperative complications occurred.Lymph node metastasis was in 2 cases.The mean time of removing the drainage tube was 6.8d（5-10d）.No skin necrosis was seen in inguinal region.Conclusion The laparoseopic excision of inguinal lymph nodes for vulvar carcinoma is a safe and feasible technique that appears to diminish the wound-related complications associated with the standard open approach.