外阴恶性肿瘤保留大隐静脉淋巴结清扫术改良术式的研究

Study of The Saphenous Vein Preservation during Inguinal Lymphadenec-tomyf or Vulval Malignancies

[目的]探讨外阴恶性肿瘤行腹股沟淋巴结清扫术保留大隐静脉对预后及并发症的影响。[方法]将1990年～2002年间收治的34例外阴恶性肿瘤患者随机分为两组,18例接受双侧腹股沟淋巴结清扫术时保留大隐静脉,16例结扎、切除一段大隐静脉。[结果]两组患者生存率、腹股沟区肿瘤复发率无显著性差异,切口愈合时间、感染率相似,但保留大隐静脉组下肢水肿、下肢疼痛、感觉异常等并发症较切除组明显降低。[结论]外阴恶性肿瘤行腹股沟淋巴结清扫术时保留大隐静脉不增加局部复发率,也不增加手术难度,但能降低并发症,是值得推广的改良手术方式。

To study the impact of the saphenous vein preservat ion during inguinal lymphadenectomy on prognosis and morbidity in patients with vulval malignancies.Thirty-four cases with vulval malignancies treated in our hospital from1990to2002were randomized into two groups:the saphenous vei n was preserved in18patients,ligated and partial resected in16patients during in guinal lymphadenectomy.The long term survival rate,recurrent,rate wound healing time and infection rate of the wound were not significantly different b etween the two groups.The complications including leg edema,pain and sense abnor mality were less in preserved group than that in ligated group.[Conclusions]Tech nique of inguinal lymphadenectomy with the saphenous vein preservation for vulva l malignancies are associated with a decrease risk of postoperative morbidity wi thout affecting treatment outcome.It is worthy to be recommended.