Establishment of the posterior peritoneal cavity in transumbilical single-site laparoscopic extraperitoneal path lymphadenectomy for endometrial cancer

doi:10.3877/cma.j.issn.1674-6899.2025.01.008

Abstract

Abstract:

Objective

To investigate the establishment of posterior peritoneal space in transumbilical single-site laparoscopic （TU-LESS） extraperitoneal path lymphadenectomy for staging of endometrial cancer.

Methods

Retroreview of five cases of endometrial cancer patients admitted to the Gynecological Department of the First Affiliated Hospital of Nanjing Medical University from Jan. 2024 to Mar. 2024. In all patients， posterior peritoneal cavity was established by the above procedure and abdominal paraaortic lymph node resection was performed by TU-LESS extraperitoneal approach.

Results

All 5 patients successfully established the extraperitoneal cavity and performed TU-LESS para-aortic lymph node resection. During pelvic lymph node resection， we completed three extraperitoneal route and two peritoneal cavity route surgeries.

Conclusion

TU-LESS extraperitoneal route lymphadenectomy possess the advantages of less trauma and faster rehabilitation. After adjusting the operation， we simplified the construction steps of the extraperitoneal cavity. therefore， the operation was more convenient and the success rate was higher，which was conducive to the promotion of this surgical method.

Key words: Endometrial cancer, Transumbilical single-port laparoscopy, Extraperitoneal route, Lymph node resection

Shulin Zhou, Chengyan Luo, Lin Yuan, Yi Jiang, Jiangnan Qiu, Shan Wu, Jinhui Liu, Wenjun Cheng. Establishment of the posterior peritoneal cavity in transumbilical single-site laparoscopic extraperitoneal path lymphadenectomy for endometrial cancer[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2025, 18(01): 44-47.

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URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2025.01.008

https://zhqjwkzz.cma-cmc.com.cn/EN/Y2025/V18/I01/44

Figures/Tables 3

References 19

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患者编号	年龄（岁）	术前病理	术前MR 评估结果	既往手术史
1	59	子宫内膜样腺癌	侵犯肌层深度＞1/2	无
2	61	子宫内膜样腺癌，P53 突变型	子宫内膜电切术后改变	腹腔镜胆囊切除术
3	61	子宫内膜样腺癌，部分低分化	浸润深度＜1/2 肌层	无
4	57	子宫内膜样腺癌，Ⅱ级	浸润深度＞1/2 肌层	无
5	67	中分化子宫内膜样腺癌	宫腔占位3. 8 cm ×2. 9 cm ×2. 8 cm，肌层浸润深度＜1/2	无

患者编号	年龄（岁）	术前病理	术前MR 评估结果	既往手术史
1	59	子宫内膜样腺癌	侵犯肌层深度＞1/2	无
2	61	子宫内膜样腺癌，P53 突变型	子宫内膜电切术后改变	腹腔镜胆囊切除术
3	61	子宫内膜样腺癌，部分低分化	浸润深度＜1/2 肌层	无
4	57	子宫内膜样腺癌，Ⅱ级	浸润深度＞1/2 肌层	无
5	67	中分化子宫内膜样腺癌	宫腔占位3. 8 cm ×2. 9 cm ×2. 8 cm，肌层浸润深度＜1/2	无

患者编号	淋巴结切除路径	手术时长（min）	术中出血量（ml）	术后肠道通气时间（h）	术后引流管保留天数（d）	术后住院天数（d）	盆腹腔淋巴结数量（个）	淋巴结阳性数（个）
1	腹主腹膜外路径、盆腔经腹膜腔路径	385	200	23	4	6	26	0
2	腹主腹膜外路径、盆腔经腹膜腔路径	308	100	33	4	5	21	0
3	全腹膜外路径	396	200	57	5	9	22	0
4	全腹膜外路径	235	200	25	2	5	36	8
5	全腹膜外路径	286	200	49	5	7	32	0

患者编号	淋巴结切除路径	手术时长（min）	术中出血量（ml）	术后肠道通气时间（h）	术后引流管保留天数（d）	术后住院天数（d）	盆腹腔淋巴结数量（个）	淋巴结阳性数（个）
1	腹主腹膜外路径、盆腔经腹膜腔路径	385	200	23	4	6	26	0
2	腹主腹膜外路径、盆腔经腹膜腔路径	308	100	33	4	5	21	0
3	全腹膜外路径	396	200	57	5	9	22	0
4	全腹膜外路径	235	200	25	2	5	36	8
5	全腹膜外路径	286	200	49	5	7	32	0

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