外阴癌腹股沟前哨淋巴结切除术的研究进展

doi:10.12280/gjfckx.20200314

摘要/Abstract

摘要：

外阴癌的主要转移方式是淋巴结转移,存在淋巴结转移的患者5年生存率仅有25%~41%,严重影响患者的预后。传统的方式是外阴局部根治性切除术+腹股沟淋巴结清扫术,但是腹股沟淋巴结清扫由于手术范围大、创伤大,同时也带来了较高术后并发症如淋巴水肿、淋巴囊肿和切口延迟愈合等,尤其长期的下肢淋巴水肿,是最严重的长期并发症,影响患者术后后续治疗、生活质量甚至预后。腹股沟前哨淋巴结是外阴癌淋巴结转移的第一站,在病理学上是最有意义的淋巴结,如果前哨淋巴结无转移可以认为后面的淋巴结也无转移,因此可以避免进行系统的腹股沟淋巴结清扫,从而减少手术创伤,缩小手术范围,降低术后并发症的风险,提高生活质量。

关键词: 外阴肿瘤, 前哨淋巴结, 淋巴结切除术, 腹股沟, 放射性示踪剂, 肿瘤复发,局部

Abstract:

The main metastasis method of vulvar cancer is lymph node metastasis. The 5-year survival rate of patients with lymph node metastasis is only 25%~41%, which seriously affects the prognosis of patients. However, due to the large scope and trauma of inguinal lymph node dissection, it also brings high postoperative complications such as lymphedema, lymphocysts, delayed wound healing, etc., especially the long-term lower extremity lymphedema, which is the most serious long-term complication, affecting the postoperative follow-up treatment, quality of life and even the prognosis of patients. The inguinal sentinel lymph node is the first stop of lymph node metastasis in vulvar cancer, and it is the most meaningful lymph node in pathology. If there is no metastasis in the sentinel lymph node, it can be considered that the posterior lymph node has no metastasis. Sentinel lymph node biopsy can thereby reduce surgical trauma, reduce the scope of surgery, reduce the risk of postoperative complications, and improve the quality of life.

Key words: Vulvar neoplasms, Sentinel lymph node, Lymph node excision, Groin, Radioactive tracers, Neoplasm recurrence,local

卢艳, 姚德生. 外阴癌腹股沟前哨淋巴结切除术的研究进展[J]. 国际妇产科学杂志, 2021, 48(1): 66-70.

LU Yan, YAO De-sheng. Advances in the Inguinal Sentinel Lymph Nodes Biopsy for Vulvar Carcinoma[J]. Journal of International Obstetrics and Gynecology, 2021, 48(1): 66-70.

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