前庭大腺癌应用脱细胞真皮填充保留外阴手术一例并文献复习

Bartholin gland carcinoma treated with acellular dermal matrix filling and vulvo-sparing surgery:a case report and literature review

总结1例前庭大腺癌应用脱细胞真皮(ADM)填充外阴术口及右侧腹股沟淋巴结清扫术野缺损的手术体会。对2022年9月陕西省第二人民医院妇产科收治的1例右侧前庭大腺癌实施保留外阴手术、右侧腹股沟淋巴结清扫及缺损部位应用脱细胞真皮(ADM)填充的围手术期护理进行总结和分析。手术顺利,术后第7 d腹股沟术口周围水肿予以引流,8 d后愈合。会阴部术口脂肪液化,更换敷料10 d后自行愈合,ADM与组织相容度满意,未见局部组织塌陷。术后规范放化疗,至今随访良好。前庭大腺癌是外阴恶性肿瘤中的一种罕见类型,早期制定肿瘤病灶扩大切除、患侧腹股沟淋巴结清扫以保留外阴结构及形态完整,应用ADM填充术野局部组织缺损并结合系统化护理措施,以提高患者术后的生活质量。

To summarize our experience with using acellular dermal matrix(ADM)to fill the defect site of vulva-sparing surgery and right inguinal lymph node dissection in a case of Bartholin gland carcinoma.A case of right Bartholin gland carcinoma admitted to the Department of Obstetrics and Gynecology of the Second People's Hospital of Shaanxi Province in September 2022 was summarized and analyzed for perioperative nursing care,including vulva-sparing surgery,right inguinal lymph node dissection,and defect site filling with ADM.The surgery was successful,and on the 7th day after the surgery,the edema around the inguinal incision was drained,and it healed after 8 days.Perineal fat liquefaction at the surgical site self-healed after 10 days of replacement of dressings.ADM had satisfactory tissue compatibility,and no local tissue collapse was observed.Standardized postoperative radiotherapy and chemotherapy were given,and the patient has good follow-up results so far.Bartholin gland carcinoma is a rare type of malignant tumor of the vulva.Extensive tumor resection and affected inguinal lymph node dissection should be performed in the early stage to preserve the integrity of the structure and morphology of the vulva.ADM can be used to fill the local tissue defect in the surgical field and combined with systematic nursing measures to improve the quality of life of patients after operation.