外阴恶性肿瘤腹股沟淋巴结清扫术中保留大隐静脉在降低术后并发症中的价值

Saphenous vein sparing during inguinal lymphadenectomy to reduce post-operative complications for patients with vulvar carcinoma

目的:探讨外阴恶性肿瘤腹股沟淋巴结清扫术中保留大隐静脉主干对降低术后并发症的作用。方法:将1989年1月-2005年12月期间住院并行双侧腹股沟淋巴结清扫术的64例外阴恶性肿瘤患者分为两组,31例行双侧腹股沟淋巴结清扫术时保留双侧大隐静脉主干,33例结扎、切除一段大隐静脉,对两组患者的术后急慢性并发症进行比较。结果:两组患者的手术时间、术中出血量均无显著差别,切口愈合时间、感染率相似,但下肢急慢性水肿、下肢疼痛、下肢软组织炎症发生率、感觉异常等并发症在保留大隐静脉组较切除组均明显降低。结论:外阴恶性肿瘤行腹股沟淋巴结清扫术时保留双侧大隐静脉主干不延长手术时间,不增加手术难度,但能明显降低多种术后并发症的发生率,提高了患者的生活质量。

Objective,To study the influence of saphenous vein sparing during inguinal lymphadenectomy on post-operative complications for patients with vulvar malignancies. Methods：Inguinal lymphadenectomy was performed on 64 patients with vulvar malignancies in our hospital from 1989 Jan to 2005 Dec. They were divided into two groups： saphenous vein sparing group （n=31） and saphenous vein ligation group （n= 33）. The post-operative short- and long-term complications were compared between the two groups. Results： There was no significant difference in operating time and intraoperative blood loss between the two groups. The two groups were similar in regard to healing time and infection rate. But the incidence of short- and long-term edema, lower limbs pain, cellulitis, and sense abnormality significantly decreased in spared group compared with ligated group. Condusions：Saphenous vein sparing during inguinal lymphadenectomy against vulvar malignancies does not elongate operating time and did not increase operation difficulty. But it significantly reduces the multiple postoperative complications and improved the life qualities of patients.