진행성 자궁경부암 환자에서 단일공 복강경을 이용한 후복막 병기설정술 1예
A case of single-site-incisional extraperitoneal laparoscopic staging surgery in locally advanced cervical cancer
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진행성 자궁경부암에서 항암요법 후 대동맥주위와 온엉덩림프절에 생기는 전이는 재발에 있어 고위험 인자로 작용한다. 저자들은 거대(bulky)병기 IIb2 자궁경부암 환자에서 단일절개로 후복강 복강경림프절절제술을 시행한 수술적 병기설정에 관한 내용을 나타내고자 하였다. 51세 자궁경부암 병기 IIb2 환자를 단일공의 후복강 접근방법으로 수술적 병기설정을 시행하였다. 수술 시간은 115분이었고, 수술 중합병증은 없었으며 떼어낸 총 35개의 림프절에서 전이 소견을 보이지 않았다. 진행성 자궁경부암 환자에서 단일절개후복강복강경을 이용한 온엉덩과 대동맥주위림프절절제술은 전신 전이의 위험성을 식별하고, 광범위방사선 그리고/또는 항암치료의 필요성을 평가하기 위한안전하고 적절한 방법이다. 이 수술의 장점은 미용적 효과뿐 아니라 비슷한 수술 시간 내에 비슷한 수의 림프절을 얻을 수 있었다고 할 수있겠다.
Abstract
Para-aortic and common iliac node metastases are high risk factors of recurrence after chemoradiation in advanced cervical cancer. We aim to present the first Korean case of extraperitoneal laparoscopic lymphadenectomy by single site incision in the surgical staging of patients with bulky stage IIB2 cervical cancer. A 51-year-old woman with stage IIB2 cervical cancer were surgically staged by retroperitoneal approach. The operating time was 115 minutes and there were no intraoperative complications. Thirty five nodes were collected and none of which were negative for metastasis. Single site incision extraperitoneal laparoscopic common iliac and para-aortic lymphadenectomy is a safe and feasible procedure to identify the risk of systemic metastasis and to assess the need for extended-field radiation and/or chemotherapy in patients with advanced cervical cancer. The advantages of this surgery are comparable harvested nodes and operating time as well as cosmetic effect
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