Recently, the team led by Professor Wang Lijuan and Professor Bao Lijun from Department of Obstetrics and Gynecology of the First Affiliated Hospital of Xi’an Jiaotong University (XJTU) successfully performed one case of minimally invasive surgery for endometrial cancer under fluorescence laparoscopy, which provided precise minimally invasive treatment and brought clinical benefits to the patient.
A 36-year-old patient, Xiao Ping (pseudonym), was diagnosed with stage 1A moderately-differentiated endometrial cancer due to irregular menstruation. She was abnormally obese with body weight of more than 100 kg and BMI of 36, which significantly increased the surgical difficulty. After outpatient visiting, Professor Wang Lijuan and Professor Bao Lijun carefully performed various physical examinations for the patient. She was hospitalized after her physical conditions were evaluated.
The team delivered preoperative consultation. Considering the situation of early-stage endometrial cancer and demanding and risky surgery for obese patients, conventional lymph node dissection may significantly increase the risk of postoperative complications. Finally, the team decided to perform resection of the whole uterus, bilateral appendages and sentinel lymph node under fluorescence laparoscopy. This minimally invasive procedure can accurately assess the lymph node status, which is a therapeutic option recommended by the latest clinical guideline on obstetrics and gynecology.
After explicit preoperative preparation, with intimate cooperation from Department of Pathology, Department of Radiology and Department of Anesthesiology and Perioperative Medicine, the team led by Professor Wang Lijuan and Professor Bao Lijun successfully performed resection of the whole uterus, bilateral appendages and sentinel lymph node under fluorescence laparoscopy for Xiao Ping. Intraoperatively, under the guidance of indocyanine green tracing and navigation, two professors obtained the sentinel lymph nodes that were the earliest and most likely to metastasize guided by precise localization of sentinel lymph nodes, avoided excessive lymph node resection and mitigated surgical trauma, which not only reduced the complications of systematic lymph node dissection, but also accurately evaluated the status of lymph node metastasis, thereby safeguarding the quality of life of this patient. Intraoperative blood loss was estimated as 100 ml. After the operation, the patient was recovered well and discharged for subsequent follow-up under attentive nursing care from the gynecological nursing team.
According to the latest research and guideline recommendations, use of minimally invasive surgery under fluorescence laparoscopy for sentinel lymph node resection can replace systematic lymph node dissection, achieve precise tumor treatment, individualized treatment for abnormally obese patients, reduce the risk of surgical complications and significantly enhance the diagnostic and therapeutic levels of endometrial cancer. Professor Wang Lijuan and Professor Bao Lijun actively have attempted to make novel explorations and applied the latest medical research outcomes into clinical practice, offering more precise, humanized and individualized medical services for patients.
