腹腔镜左肾静脉水平淋巴结清扫新技术在早期卵巢癌中的应用效果  

Application effect of laparoscopic left renal vein horizontal para-aortic lymphadenectomy in early ovarian cancer

作　　者：兰燕芳 胡旻 金兰英[1] LAN Yan-fang;HU Min;JIN Lan-ying(Department of Gynecology,Jinhua Municipal Central Hospital,Jinhua,Zhejiang 321000,China;不详)

机构地区：[1]金华市中心医院妇科,浙江金华321000 [2]金华市妇幼保健院妇科

出　　处：《中国妇幼保健》2024年第24期5013-5016,共4页Maternal and Child Health Care of China

基　　金：浙江省医药卫生科技计划项目(2021KY388)。

摘　　要：目的探讨腹腔镜左肾静脉水平淋巴结清扫新技术在早期卵巢癌中的应用效果。方法选择2015年1月—2022年12月在金华市中心医院、金华市妇幼保健院接受腹腔镜左肾静脉水平淋巴结清扫治疗的83例早期卵巢癌患者为研究对象,其中42例患者实施腹腔镜左肾静脉水平淋巴结清扫新技术,作为研究组;41例患者实施常规的腹腔镜左肾静脉水平淋巴结清扫,作为对照组。记录两组患者的手术时间、术中出血量、住院时间、获取腹主动脉旁淋巴结数量、并发症发生率,评估两种手术方法的有效性及术后生存情况。结果研究组患者手术时间为(190.3±18.7)min,术中出血量为(59.7±16.4)ml,均明显低于对照组的(216.8±28.0)min与(103.0±34.6)ml,差异均有统计学意义(均P<0.05)。研究组获取腹主动脉旁淋巴结数量为(19.7±6.7)个,多于对照组的(15.6±5.8)个,差异有统计学意义(P<0.05)。研究组乳糜漏发生率高于对照组(P<0.05)。研究组无病生存率(88.1%)高于对照组(82.9%),但差异无统计学意义(P>0.05)。结论以通过转换手术者站立位置,联合使用三叶或五叶扇形钳拨挡肠管等手术技巧为主的腹腔镜左肾静脉水平淋巴结清扫新技术治疗早期卵巢癌时能减少术中出血量,提高患者恢复速度和存活率,具有临床推广价值,但需要进一步探寻有效措施来预防乳糜漏的发生。Objective To explore the application effect of laparoscopic left renal vein horizontal para-aortic lymphadenectomy in early ovarian cancer.Methods A total of 83 patients with early ovarian cancer undergoing laparoscopic left renal vein horizontal para-aortic lymphadenectomy in Jinhua Municipal Central Hospital and Jinhua Maternal and Child Health Care Hospital from January 2015 to December 2022 were selected and divided into study group(42 patients,new technique of laparoscopic left renal vein horizontal para-aortic lymphadenectomy)and control group(41 patients,routine laparoscopic left renal vein horizontal para-aortic lymphadenectomy).The operation time,the amounts of blood loss during operation,hospitalization time,the numbers of para-aortic lymph node,and incidence rates of complications in the two groups were recorded.The effectiveness and postoperative survival rates of the two surgical methods were evaluated.Results The operation time in study group was(190.3±18.7)minutes,the amount of blood loss during operation was(59.7±16.4)ml,which were significantly lower than those in control group[(216.8±28.0)minutes and(103.30±34.6)ml],there were statistically significant differences(P<0.05).The number of para-aortic lymph node in study group was(19.7±6.7),which was more than that in control group(15.6±5.8),there was statistically significant difference(P<0.05).The incidence rate of chylous fistula in study group was statistically significantly higher than that in control group(P<0.05).The disease-free survival rate in study group was 88.1%,which was higher than that in control group(82.9%),but there was no statistically significant difference(P>0.05).Conclusion Through the conversion of operator's standing position,combined use of three or five leaf blade forceps surgical skills such as laparoscopic left renal vein level lymph node dissection new technology in treatment of early ovarian cancer can reduce intraoperative bleeding volume,improve recovery speed and prolong survival rate,which has clinical promot

关 键 词：腹腔镜左肾静脉水平淋巴结清扫 早期卵巢癌 应用效果 

分 类 号：R737.31[医药卫生—肿瘤]