妇科癌症患者盆腔淋巴结检索数量与同侧下肢淋巴水肿之间的关系

IF 2.1 4区 医学 Q2 SURGERY Journal of Investigative Surgery Pub Date : 2022-05-01 Epub Date: 2021-09-21 DOI:10.1080/08941939.2021.1980160
Sang Geun Jung, Sang Hee Im, Migang Kim, Min Chul Choi, Won Duk Joo, Seung Hun Song, Chan Lee, Hyun Park
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引用次数: 0

摘要

目的:虽然妇科恶性肿瘤根治术后发生下肢淋巴水肿(LLE)的风险是多因素的,但淋巴结(LN)的有限评估,如前哨LN活检,已被纳入标准程序。我们评估了从半盆腔取出的LN数量与同侧LLE(iLLE)发生率之间的关系:这项回顾性研究纳入了2014年1月至2018年12月期间通过微创手术切除LN的103名妇科癌症女性。为早期发现LLE,患者由符合国际淋巴水肿协会标准的淋巴水肿专家进行随访。收集了淋巴结核性白血病的潜在风险因素,并根据切除的淋巴结数量以特定侧的方式对风险因素进行了进一步调查:32名(31.1%)患者被诊断为淋巴结肿大,其中大多数被诊断为单侧淋巴结肿大(22人),而非双侧(10人)。切除的盆腔LN数量(p = 0.018)、未绘制淋巴图(p = 0.034)和放射(p = 0.020)与单侧或双侧LLE的发生有关。针对一侧的分析显示,从半盆切除四个或更多LN时,iLLE的发生率明显高于切除三个或更少的LN(22.9% vs. 8.3%,p = 0.048):结论:在早期妇科癌症患者中,盆腔LN的取材数量与LLE的发生率有关。我们通过对每侧的特异性分析确定了可将iLLE风险降至最低的每个半骨盆的临界数量。我们还需要进一步的研究来验证我们的结果。
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The Association Between the Number of Retrieved Pelvic Lymph Nodes and Ipsilateral Lower Limb Lymphedema in Patients With Gynecologic Cancer.

Purpose: While the risk of lower limb lymphedema (LLE) after radical surgery for gynecologic malignancies is multifactorial, the limited assessment of lymph nodes (LNs), such as sentinel LN biopsy, has been incorporated into a standard procedure. We assessed the relationship between the number of LNs retrieved from the hemipelvis and the incidence of ipsilateral LLE (iLLE).

Methods: This retrospective study included 103 women with gynecologic cancer who had LNs removed with minimally invasive surgery between January 2014 and December 2018. For early detection of LLE, the patients were followed up by a lymphedema specialist who complied with the International Society of Lymphedema criteria. Potential risk factors for LLE were collected, and the risk factors were further investigated according to the number of LNs removed in a side-specific manner.

Results: LLE was diagnosed in 32 (31.1%) patients, and most of them were diagnosed with unilateral (n = 22) LLE rather than bilateral (n = 10). The number of pelvic LNs removed (p = 0.018), no lymphatic mapping (p = 0.034), and radiation (p = 0.020) were associated with the development of one or both LLEs. A side-specific analysis revealed that the incidence of iLLE increased significantly when four or more LNs were removed from the hemipelvis compared with three or fewer LNs (22.9% vs. 8.3%, p = 0.048).

Conclusions: The number of pelvic LNs retrieved was associated with the incidence of LLE in patients with early gynecologic cancer. We identified the cutoff number per hemipelvis through side-specific analysis that could minimize the risk of iLLE. Further studies are needed to validate our results.

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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
114
审稿时长
6-12 weeks
期刊介绍: Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.
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