通过腹膜后经阴道自然孔道腔内镜手术 (vNOTES) 方法确定子宫内膜癌 (EC) 患者前哨淋巴结 (SLN) 的解剖分布、整体、单侧和双侧检出率以及双侧 SLN 一致性.前瞻性单中心观察性研究。瑞士教学医院。2021 年 10 月至 2023 年 11 月期间，患有 EC 或子宫内膜复合体非典型增生的患者，通过腹膜后 vNOTES 方法接受了 SLN 标测手术分期。患者被置于水平背侧截石位，在全身麻醉，并将吲哚菁绿（ICG）注入子宫颈。通过阴道切口进入腹膜后空间。使用 7 cm GelPoint V-Path 经阴道接入平台作为 vNOTES 端口，并吹入 CO2 以扩大腹膜后空间。检查盆腔腹膜后间隙淋巴结对 ICG 的摄取情况。鉴定后，取出前哨淋巴结并送去进行明确的组织学检查。本研究共纳入34名患者； 33 名 (97.1%) 的手术成功（单侧或双边标测），1 名 (2.9%) 标测失败。总共识别并删除了 124 个 SLN。在闭孔区（81.5%）、髂外区（10.5%）、髂内区（4.8%）和髂总区（3.2%）观察到前哨淋巴结。在骨盆两侧观察到相似的比例。其他地区未检测到 SLN。 22/31 (71.0%) 患者的 SLN 位置是对称的。 120 例 (96.8%) SLN 呈阴性，2 个淋巴结 (1.6%) 呈现孤立的肿瘤细胞，另外 2 个淋巴结 (1.6%) 呈现巨大转移。我们报告了通过腹膜后 vNOTES 绘制的 SLN 的解剖分布和检出率。我们的结果表明，与腹腔镜标测报告相比，SLN 的定位存在显着差异。版权所有 © 2024。由 Elsevier Inc. 出版。

To determine the anatomical distribution of sentinel lymph nodes (SLNs), the overall, unilateral, and bilateral detection rates, and the bilateral SLN concordance in patients with endometrial cancer (EC) mapped through a retroperitoneal transvaginal natural orifice transluminal endoscopic surgery (vNOTES) approach.Prospective single-center observational study.Swiss teaching hospital.Patients with EC or endometrial complex atypical hyperplasia who had undergone surgical staging with SLN mapping by a retroperitoneal vNOTES approach between October 2021 and November 2023.Patients were placed in a horizontal dorsal lithotomy position under general anesthesia, and indocyanine green (ICG) was injected into the cervix. Access to the retroperitoneal space was achieved through vaginal incisions. A 7 cm GelPoint V-Path Transvaginal Access Platform was used as a vNOTES port, and CO2 was insufflated to expand the retroperitoneal space. The pelvic retroperitoneal space was inspected for ICG uptake by lymph nodes. After identification, SLNs were removed and sent for definitive histological examination.A total of 34 patients were included in this study; 33 (97.1%) had a successful procedure (unilateral or bilateral mapping), and 1 (2.9%) had failed mapping. A total of 124 SLNs were identified and removed. SLNs were observed in the obturator region (81.5%), the external iliac region (10.5%), the internal iliac region (4.8%), and the common iliac region (3.2 %). Similar proportions were observed on both pelvic sides. No SLNs were detected in other regions. The SLN locations were symmetrical in 22/31 (71.0%) patients. SLNs were negatives in 120 cases (96.8%), while 2 lymph nodes (1.6%) presented isolated tumor cells, and 2 others (1.6%) presented macrometastases.We report anatomical distributions and detection rates for SLNs mapped by retroperitoneal vNOTES. Our results suggest substantial differences in the localization of SLNs compared to those reported for laparoscopic mapping.Copyright © 2024. Published by Elsevier Inc.