阴茎癌改良预防性腹股沟淋巴结清扫术30例报告  

Prophylactic inguinal lymphadenectomy with preservation of the saphenous vein for carcinoma of the penis （Report of 30 cases）

作　　者：梁宇[1,2] 袁俊斌[1] 陈敏丰[1] 祖雄兵[1] 蔡雅富[2] 任胜强[2] 

机构地区：[1]中南大学湘雅医院泌尿外科,长沙410008 [2]浙江宁波解放军第113医院泌尿外科

出　　处：《中国男科学杂志》2013年第10期30-32,38,共4页Chinese Journal of Andrology

摘　　要：目的：在阴茎癌预防性淋巴结清扫术中保留大隐静脉，以期降低术后并发症的发生率及其严重程度。方法回顾性分析我院从2006年1月至2010年6月对30例阴茎癌患者施行改良的预防性腹股沟淋巴结清扫术。在标准腹股沟淋巴结清扫术清扫界限上，外侧缘和下缘减少1-2cm范围，清除区域内浅深组淋巴和脂肪组织，其中保留大隐静脉。结果两腹股沟区淋巴结共检出68枚，平均2.3枚，病理证实阳性共3例3枚淋巴结，10%的患者淋巴结转移。术后1例患者出现切口感染和高热，1例发生单侧下肢水肿，另有18.3%的单侧腹股沟区域出现局部并发症，包括切口感染、皮缘轻度坏死以及愈合延迟、淋巴瘘。无一例出现皮瓣大面积坏死、囊状淋巴管瘤和深静脉血栓等严重的并发症，三年无进展生存率100%。结论对阴茎癌患者，在保留大隐静脉的预防性腹股沟淋巴结清扫术保证淋巴转移灶被清扫的同时，也降低了并发证的发生率和严重程度。Objective To evaluate the postoperative complications of penile cancer by prophylactic inguinal lymphadenectomy with preservation of the saphenous vein.Methods Clinical data of 30 patients with penile cancer who underwent prophylactic bilateral inguinal lymphadenectomy with saphenous vein sparing between January 2006 and June 2010, were retrospectively reviewed. The superficial and deep inguinal lymph nodes were included in inguinal lymphadenectomy andthe saphenous vein was preserved, skin incision was shortened （reducing the lateral and inferior margin 1-2cm compared to the standard inguinal lymphadenectomy boundary line）.Results The total number of bilateral inguinal lymph nodes dissected was 68, the average number 2.3. The pathologic examination showed 10% patients had lymph node metastasis （3 positive nodes in 3 patients）. Serious complications occurred in two patients. One encountered wound infection and high fever, the other encountered leg edema. Local complications occurred in 18.3% cases. There was no serious complication such as dreadful flap necrosis, deep venous thrombosis or cystic lymphoceles. 3-Year progression-free survival rate was 100%.Conclusion Inguinal lymphadenectomy with saphenous vein sparing may reduce the ocurrence of complications.

关 键 词：阴茎肿瘤 淋巴结切除术 手术后并发症 

分 类 号：R737.27[医药卫生—肿瘤]