The Effect Of Renal Vein Level Lymphadenectomy In Laparoscopic Radical Resection For Patients With Stage Ⅰb～Ⅲ Type Ⅰ Endometrial Carcinoma Cancer

Purpose: Laparoscopic pelvic and abdominal lymph node resection is an important step in endometrial cancer surgery,but whether to perform renal vein level lymph node resection has always been controversial.This article will perform renal vein level in patients with stage Ib to III type I endometrial cancer And inferior mesenteric artery level lymph node resection,comparing the effects of two surgical treatments.Methods: A total of 65 patients with type I endometrial cancer in our hospital from March 2017 to May 2019 were selected and divided into the renal vein(RV)group with 33 cases and the inferior mesenteric artery(IMA)group with 32 cases according to the odd-even order.Both groups underwent total hysterectomy and double appendectomy and pelvic lymphadenectomy and para-aortic lymph node resection.The para-aortic lymph nodes in the RV group were removed to the level of the renal vein,and the abdominal para-aortic lymph nodes in the IMA group were removed to the inferior mesenteric artery.The two groups were compared with exhaust time,intraoperative blood loss,operation time,hospital stay,postoperative complication rate,postoperative para-aortic lymph node metastasis rate,recurrence rate and followup for 12 months.Results: Compared with the IMA group,the RV group had no significant difference in exhaust time and total intraoperative blood loss(P>0.05);the RV group took longer to operate and the hospital stay was longer than the IMA group(P<0.05);the RV group had complications The incidence of symptom 9.09%(3/33)compared with 18.75%(6/32)in the IMA group,there was no significant difference(P>0.05);the metastatic rate of para-aortic lymph nodes in the high group was 3.03%(1/33)lower than that of the low group 21.88%(7/ 32)(P<0.05);the recurrence rate of the high group was6.45%(2/31)lower than that of the low group 30.0%(9/30)(P<0.05).Conclusion: Compared with inferior mesenteric artery level lymph node resection,renal vein level lymph node resection is used during laparoscopic radical resection for patients with with stage Ib to III type I endometrial cancer,which does not increase the incidence of postoperative complications and reduces the metastasis of abdominal aortic lymph nodes.Risk,reduce postoperative recurrence.