子宮体癌における腹腔鏡下後腹膜リンパ節郭清術の徹底度に関する考察〜部位別摘出リンパ節個数の観点から

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Objective: This study was conducted to assess the validity of laparoscopic lymphadenectomy for gynecologic malignancies at our hospital.Methods: Twenty-five patients undergoing laparoscopic (LS) paraaortic and pelvic lymphadenectomy for endometrial carcinoma were compared with 21 control subjects similarly treated via laparotomy (LT). Only surgeries involving systematic lymphadenectomy were included. Extracted lymph nodes were classified using The General Rules for Clinical and Pathological Management of Uterine Cervical Cancer1). For the two groups, the count of nodes retrieved was analyzed by region. Result: PAN and PLN lymph node totals were similar with either technique. However, comparatively fewer lymph nodes were obtained from left common iliac regions of the LS group.Conclusion: These data suggest that complete removal of nodes from the left common iliac region may be difficult with a laparoscopic retroperitoneal approach. This potential pitfall must be recognized and care taken for thorough dissection in this area.