阴道断端半开放缝合对淋巴结清扫术后盆腔淋巴囊肿预防作用研究  

Effectiveness of semi-open suturation of vaginal stump in prevent the development of pelvic lymphocele after pelvic lymphadenectomy

作　　者：王珮瑶 张丹晔[1] 刘娟娟[1] 齐跃[1] 朱连成[1] 任芳[1] 王慧敏[1] 林蓓[1] WANG Pei-yao;ZHANG Dan-ye;LIU Juan-juan;QI Yue;ZHU Lian-cheng;REN Fang;WANG Hui-min;LIN Bei(Department of Obstetrics and Gynecology,Shenjing Hospital Affiliated to China Medical University,Liaoning ,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院妇产科,辽宁沈阳110004

出　　处：《中国实用妇科与产科杂志》2019年第1期107-113,共7页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：盛京自由研究者计划(201303)

摘　　要：目的探讨阴道断端半开放缝合对淋巴结清扫术后盆腔淋巴囊肿的预防作用。方法收集2012年1月至2018年9月中国医科大学附属盛京医院术中同时行盆腔和(或)腹主动脉旁淋巴结切除的子宫内膜癌及宫颈癌患者348例。根据阴道断端处理方式不同,将348例患者分为半开放组102例与闭合组246例。回顾性比较两组患者手术时间、清扫淋巴结个数、术后引流时间、术后白蛋白含量及血红蛋白含量上的差异,淋巴囊肿发生率及症状型淋巴囊肿发生率。结果半开放组与闭合组在手术时间、清扫淋巴结个数、术后引流时间、术后白蛋白含量及血红蛋白含量上差异均无明显统计学意义(P均>0.05),半开放组术后淋巴囊肿发生率及症状型淋巴囊肿发生率分别为35.3%、3.9%,均明显低于闭合组(79.3%、19.5%);形成淋巴囊肿平均直径4.1cm也明显低于闭合组5.9cm,差异均具有统计学意义(P均<0.05)。结论淋巴结清扫术后半开放缝合阴道断端是预防术后盆腔淋巴囊肿形成的有效途径,方法简单、效果可靠,无手术难度,不增加术后并发症,值得临床推广。Objective To evaluate the effectiveness of semi-open suturation of vaginal stump in preventing pelvic lym-phocele after pelvic lymphadenectomy during gynecologic cancer surgery.MethodsThis study is a retrospectivestudy.Totally 348 patients with cervic cancer or endometrial cancer who underwent pelvic lymphadenectomy and/or para-aortic lymphadenectomy from January 2012 to September 2018 were divided into two groups according to the suturationof vaginal stump:102 patients were in the semi-open group and 246 patients were in the closed group.The two groupswere compared concerning the surgery time,harvested lymph node,drainage time,albumin level,hemoglobin content,and the incidence of lymphocele and symptomatic lymphocele.ResultsThere were no differences between two groupswith respect to surgery time,harvested lymph node,drainage time,albumin level or hemoglobin content(P>0.05).Theincidence of lymphocele and symptomatic lyphocele in semi-open group was significantly lower than that in closed group(35.3%versus79.3%,3.9%versus19.5%,P<0.05);the average diameter of lymphocele in semi-open group was also sig-nificantly lower than that in closed group(4.1cm versus 5.9cm,P<0.05).ConclusionThe result of this study indicatesthat the application of semi-open saturation of vaginal stump is an effective way to reduce the incidence of pelvic lym-phocele after gynecologic malignancy,which is simple and with reliable effect.It doesn′t increase the incidence of postop-eration complications and deserves clinical application.

关 键 词：阴道断端半开放缝合 妇科恶性肿瘤 盆腔淋巴囊肿 预防 

分 类 号：R711.74[医药卫生—妇产科学]