目的:本研究的目的是探讨在根治性外阴切除术双侧腹股沟淋巴结清扫术中应用缝匠肌腱转位与缝匠肌腱转位的临床效果。
方法:2007年5月至2013年10月共58例接受手术的外阴癌患者,其中30例患者接受了sartorius移位术,28例患者接受了sartorius肌腱移位术。所有患者均按年龄匹配,身体质量指数,舞台,组织学,和等级。术中变量和术后并发症,复发,无进展生存期(PFS),并对两组患者的总生存期(OS)和术后生活质量进行比较分析。
结果:在中位手术时间和出血量方面没有发现显着差异(分别为p=0.316和p=0.249),在腹股沟蜂窝织炎和淋巴囊肿的发生率(分别为p=0.673和p=0.473),但肌腱移位组的腹股沟伤口恢复时间较短(p=0.026),伤口破裂和慢性淋巴水肿的发生率显着降低(分别为p=0.012和p=0.022)。如EORTCQLQ-C30问卷所示,肌腱转位组术后生活质量明显改善。复发相似(p=0.346),在PFS和OS上没有发现显着差异(分别为p=0.990和p=0.683)。
结论:与sartorius转位相比,腹股沟淋巴结清扫术中的缝匠肌腱转位改善了患者的恢复,减少术后并发症,并在不影响结果的情况下提高生活质量。
OBJECTIVE: The aim of this study was to investigate the clinical effects of sartorius tendon transposition versus sartorius transposition during bilateral inguinal lymphadenectomy of radical vulvectomy.
METHODS: A total of 58 vulvar cancer patients who had surgery from May 2007 to October 2013, in which 30 patients received sartorius transposition and 28 patients received sartorius tendon transposition. All patients were matched by age, body mass index, stage, histology, and grade. Intraoperative variables and postoperative complications, recurrence, progression-free survival (PFS), and overall survival (OS) and postoperative life quality were compared and analyzed.
RESULTS: No significant differences were found at median surgical times and amounts of bleeding (p=0.316 and p=0.249, respectively), neither at the incidences of groin cellulitis and lymphocele (p=0.673 and p=0.473, respectively), but the recovery times of the inguinal wounds were shorter (p=0.026) and the incidences of wound break and chronic lymphedema were significantly decreased in the tendon transposition group (p=0.012 and p=0.022, respectively). Postoperative quality of life in tendon transposition group was significantly improved as indicated by the EORTC QLQ-C30 questionnaire. Recurrences were similar (p=0.346) and no significant differences were found at PFS and OS (p=0.990 and p=0.683, respectively).
CONCLUSIONS: Compared to sartorius transposition, sartorius tendon transposition during inguinal lymphadenectomy led to improved patient recovery, reduced postoperative complications, and improved life quality without compromising the outcomes.