经改良腹膜后径路腹腔镜下腹膜后淋巴结清扫术:附9例报告  

Laparoscopic retroperitoneal radical lymphadenectomy in 9 cases

作　　者：秦超[1] 殷长军[1] 孟小鑫[1] 李杰[1] 邵鹏飞[1] 李鹏超[1] 李普[1] 王美林[2] 张正东[2] 吕强[1] 顾民[1] 张炜[1] 

机构地区：[1]南京医科大学第一附属医院泌尿外科,南京210029 [2]南京医科大学公共卫生学院

出　　处：《中华腔镜泌尿外科杂志（电子版）》2011年第2期8-10,共3页Chinese Journal of Endourology(Electronic Edition)

基　　金：江苏省卫生厅开放课题资助项目(XK17200901)

摘　　要：目的探讨腹腔镜腹膜后淋巴结清扫术的临床可行性,并总结手术技巧。方法对9例睾丸非精原细胞瘤型生殖细胞瘤患者,行根治性睾丸切除术后平均27d行改良腹膜后径路腹腔镜腹膜后淋巴结清扫术。结果 9例手术均获成功,术中发生下腔静脉损伤1例,腹腔镜下缝合。平均手术时间170min,平均出血量330ml,术后肠功能恢复时间约2d,引流管均于术后第3天拔除,平均住院时间7d。术后随访分别为18±8个月,无复发及转移。结论经改良腹膜后径路行腹腔镜腹膜后淋巴结清扫可避免对腹腔脏器的影响,解剖结构显露较满意,具有创伤小、恢复快等优点,是一种临床可进一步应用的手术方式。Objective To investigate surgical techniques and the clinical feasibility of laparoscopic retroperitoneal lymph node dissection（EL-RPLND）.Methods Nine patients with primary testicular nonseminomatous germ cell tumors（NSGCT） received EL-RPLND several weeks after orchiectomy.Results The EL-RPLND was successfully performed in all 9 patients.The operating time was 170 min,the intraoperative blood loss was 330 ml,the postoperative intestinal function recovery time was 2 days,and the average hospital stay was 7 days.Follow-up revealed no evidence of recurrence or distant metastasis.Conclusions Because it is not a difficult and complicated procedure performed via our improved retroperitoneoscopic approach,EL-RPLND can be further applied as an operation for low-stage nonseminomatous testis cancer.

关 键 词：睾丸 非精原细胞瘤 腹膜后径路腹腔镜 腹膜后淋巴结清扫 

分 类 号：R737.21[医药卫生—肿瘤]