背景：视频内镜腹股沟淋巴结清扫术（VEIL）比开放手术治疗外阴癌的并发症少。没有高水平的证据比较VEIL的两种途径（VEIL-H和VEIL-L）的疗效和安全性。
方法：我们对2000年至2020年关于VEIL治疗外阴癌的报道进行了全面的文献检索，并回顾了我们的经验。数据提取包括患者特征，围手术期指标,术后并发症,和癌症复发。
结果：共有11项符合条件的研究纳入了系统评价。九项研究仅包括一条VEIL途径，其他两项研究直接比较了VEIL的两种途径。VEIL-L组平均手术时间为85(range,33-180.12）分钟，VEIL-H组为112(范围，35-170.79）分钟。VEIL-L组的平均失血量为9（范围，5-30)mL,VEIL-H组为96（范围，5.5-214.8)mL。VEIL-L组术中平均切除淋巴结数为9（范围，7.5-13.2),在VEIL-H组中为14（范围，9.5-16).两组之间的癌症复发率没有显着差异。我们在队列研究中发现了类似的结果。
结论：手术时间，术中失血,VEIL-L程序的引流时间似乎少于VEIL-H程序的引流时间。VEIL-L和VEIL-H在淋巴结清扫术中疗效相当，手术相关并发症,和癌症复发率。
BACKGROUND: Video endoscopic inguinal lymphadenectomy (VEIL) has fewer complications than open surgery for vulva cancer. No high-level evidence comparing the efficacy and safety of the two routes of VEIL (VEIL-H and VEIL-L) is available.
METHODS: We performed a comprehensive literature search for reports on VEIL for vulva cancer from 2000 to 2020 and reviewed our experience. Data extraction includes patients\' characteristics, perioperative indicators, postoperative complications, and cancer recurrence.
RESULTS: A total of 11 eligible studies were included in the systematic
review. Nine studies included only one route of VEIL, and the other two studies directly compared the two routes of VEIL. The average operation time of the VEIL-L group was 85 (range, 33-180.12) minutes, and that of the VEIL-H group was 112 (range, 35-170.79) minutes. The average blood loss of the VEIL-L group was 9 (range, 5-30) mL, and that of the VEIL-H group was 96 (range, 5.5-214.8) mL. The average number of intraoperatively removed lymph nodes in the VEIL-L group was 9 (range, 7.5-13.2), and that in the VEIL-H group was 14 (range, 9.5-16). No significant difference was observed in the cancer recurrence rate between the two groups. We found similar results in our cohort study.
CONCLUSIONS: The operation time, intraoperative blood loss, and time of drainage of the VEIL-L procedure seemed less than those of the VEIL-H procedure. VEIL-L and VEIL-H were equivalent in the efficacy of lymph node dissection, surgery-related complications, and cancer recurrence rate.
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