Postoperative lymphocyst formation after pelvic lymphadenectomy for gynecologic cancers: comparison between laparoscopy and laparotomy
Postoperative lymphocyst formation after pelvic lymphadenectomy for gynecologic cancers: comparison between laparoscopy and laparotomy
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DOI：
10.1007/s10147-021-02052-1
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发表时间：
2022-02-04
影响因子：
3.3
通讯作者：
Kimura, Tadashi
中科院分区：
文献类型：
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作者：
Kakubari, Reisa;Kobayashi, Eiji;Kimura, Tadashi
目的 本研究的目的是使用明确的诊断标准评估妇科癌症盆腔淋巴结切除术后淋巴细胞形成的发生率，并比较腹腔镜检查和剖腹手术的发生率。方法 回顾性分析2010年3月至2016年3月期间因宫颈癌或子宫内膜癌接受盆腔淋巴结清扫术的所有患者的病历。我们将淋巴囊定义为盆腔内经超声或计算机断层扫描诊断的局限性液体集合，直径为2 cm或以上。结果 在六年的观察期内，对 196 名临床 I 期子宫癌女性进行了盆腔淋巴结切除术；腹腔镜检查90例，开腹手术106例。微创腹腔镜组的估计失血量较低（p < 0.01），住院时间较短（p < 0.01）。腹腔镜检查病例中观察到淋巴囊肿的率为 14.4% (13/90)，剖腹手术病例中观察到淋巴囊肿的率为 15.1% (16/106)，这意味着淋巴囊肿没有显着差异 (p = 1.00)。剖腹手术组有症状淋巴细胞的中位尺寸显着大于腹腔镜组（中位 4.8 厘米 vs 2.8 厘米）（p = 0.04）。有症状的淋巴细胞在剖腹手术中更常见 [7/90 (7.8%) vs 14/106 (13.2%) (p = 0.253)]。结论 在严格诊断标准的回顾性分析中，腹腔镜与开腹手术的淋巴细胞发生率无统计学差异。剖腹手术组的淋巴细胞中位尺寸较大，并且淋巴细胞可能有症状。
Purpose The goal of this study was to evaluate, using definitive diagnostic criteria, the incidence of lymphocyst formation following pelvic lymphadenectomy for gynecological cancer, and to compare rates between the approaches of laparoscopy and laparotomy. Methods We retrospectively reviewed the medical records of all patients who underwent pelvic lymphadenectomy for cervical or endometrial cancer between March of 2010 and March of 2016. We defined a lymphocyst as a circumscribed collection of fluid within the pelvic cavity, with a diameter of 2 cm or more, as diagnosed with ultrasound or computed tomography. Results During the six-year observational period, a pelvic lymphadenectomy was conducted in 196 women with clinical stage I uterine cancer; 90 cases underwent laparoscopy, 106 underwent laparotomy. The minimally invasive laparoscopic group had a lower estimated blood loss (p < 0.01), shorter hospital stay (p < 0.01). Lymphocysts were observed in 14.4% (13/90) of the laparoscopy cases, and in 15.1% (16/106) of the laparotomy cases which means no significant difference of lymphocyst (p = 1.00). The median size of symptomatic lymphocyst was significantly larger in laparotomy group than in laparoscopy group (4.8 cm v.s. 2.8 cm, median) (p = 0.04). Symptomatic lymphocysts were more common in laparotomy [7/90 (7.8%) vs 14/106 (13.2%) (p = 0.253)]. Conclusions In a retrospective analysis with a strict diagnostic criteria, we could find no statistical difference in lymphocyst occurrence between laparoscopy and laparotomy. The median size of the lymphocyst was bigger and lymphocyst was likely to be symptomatic in the laparotomy group.