单极电钩在腹腔镜盆腔淋巴结清扫术中的应用价值

Evaluation of the safety and effectiveness of monopolar hook during laparoscopic pelvic lymphadenectomy for gynecological cancer

目的:评价单极电钩在腹腔镜盆腔淋巴结清扫术中的有效性、安全性。方法:设计开放、随机、配对、前瞻性实验,比较76例腹腔镜下妇科恶性肿瘤根治术患者单侧淋巴结清扫过程中出血量、淋巴结清扫数量、手术时间、术后髂窝引流量、10周后淋巴囊肿形成率及直径等数据。结果:单极电钩清扫盆腔淋巴结较之目前较流行的超声刀清扫过程,止血效果相当,但单侧淋巴结清扫数量(13.1±4.5个)、单侧手术时间(26.3±6.1min)、单侧淋巴囊肿形成率(11/76)明显优于后者。结论:合理应用单极电钩可完成腹腔镜盆腔淋巴结清扫,治疗效果强于超声刀,可降低腹腔镜手术费用。

Objective：In this prospective randomized pilot study,we evaluated the safety and effectiveness of monopolar hook during laparoseopic pelvic lymphadenectomy for gynecological cancer, and compared to ultrasound knife. Methods： All 76 patients with gynecological cancer , who were suitable to perform laparoscopic lymphadenectomy, were randomly assigned for lymphadeneetomy in one side of the pelvis using monopolar hook, whereas, the other side using ultrasound knife. Results： Compared with the ultrasound knife, monopolar hook had the same ability in hemostasis and cutting during the pelvic lymphadeneetomy, but, make a superior performance in single - side lymph nodes dissection （ 13.1 ± 4.5 Vs 9.4 ± 3.7, P 〈 0.001 ）, operation time （26.3 ± 6.1 min Vs 39.4 ± 7.5 min , P = 0. 003 ） and lymphocele formation rate （11/76 Vs 16/76, P 〈 0. 001 ）. Conclusion： Laparoscopie pelvic lymphadeneetomy with monopolar hook is better than ultrasound knife and with decreased cost.