腹腔镜与开放手术阴茎癌腹股沟淋巴结清扫术治疗效果比较  

Effect comparison of the ingurnal lymphadenectomy with laparoscope operation and open surgery for penile cancer

作　　者：李付军[1,2] 顾朝辉[1] 丁亚飞[1] 贾占奎[1] 金志波[1] 魏金星[1] 杨锦建[1] 

机构地区：[1]郑州大学第一附属医院泌尿外科河南省泌尿外科研究所郑州市泌尿外科肿瘤分子生物学重点实验室,450052 [2]河南省商丘市民权县人民医院,476800

出　　处：《中华实验外科杂志》2014年第12期2905-2907,共3页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金资助项目（81100464、81200883）;中国博士后科学基金资助项目（2012M521410）;郑州市科技创新团队项目（131PCXTD627）

摘　　要：目的 探讨腹腔镜与开放手术治疗腹股沟淋巴结清扫术的效果.方法 遵循随机对照的实验方法,将阴茎癌患者随机分为两组,腹腔镜下腹股沟淋巴结清扫术治疗阴茎癌9例,同期按照经典的腹股沟淋巴结清扫术治疗阴茎癌9例,分析患者患侧、手术方式、原发肿瘤分期及年龄差异均无统计学意义.通过统计学分析手术时间、术中出血量、术后引流管、尿管留置时间、术后住院时间及并发症,比较两种术式的手术效果.结果 两组患者手术均获成功,无中转开放或改变术式者.腹腔镜组与开放组的手术时间分别为（157 ±20）、（127±18） min,术中出血量分别为（23±8）、（21±17）ml,清扫淋巴结分别为（14±6）、（19±6）枚,差异均无统计学意义（P＞0.05）;留置引流管时间分别为（47±10）、（161±41）h,导尿管留置时间分别为（92±46）、（175±26）h,术后住院时间分别为（6.0±0.8）、（8.0±0.5）d,差异均有统计学意义（P＜0.05）.腹腔镜组1例患者出现穿刺位点愈合延迟,余未发生其他并发症.开放组1例患者左侧切口约2 cm延迟愈合,1例患者左侧出现皮瓣漂浮,加压包扎并制动后愈合.结论 腹腔镜腹股沟淋巴结清扫术是一种安全、可行的手术方式,与开放手术比具有手术时间短、并发症少、恢复快、术后住院时间短等优势,尤其可避免皮瓣坏死、皮下血肿.Objective To study the laparoscopic and open surgery for the treatment of the ingurnal lymphadenectomy.Methods Following the randomized controlled experiment method,The patients were randomly divided into two groups,9 cases of penile cancer underwent the laparoscopic ingurnal lymphadenectomy,in the same period,9 cases of penile cancer underwent the the classic open surgery,the type of surgery patients suffering from side primary tumor stage and age differences were not statistically significant.Through the statistical analysis of the operative time,the intraoperative blood loss,the duration of the urethral catheter and the drainage time,the postoperative hospital stay and the postoperative complication,To compare the effect of two surgical operation.Results Between the two groups,the operative time was （157±20） min vs.（127 ±18） min （P〉0.05）,the intraoperative blood loss was （23 ±8） ml vs.（21 ± 17） ml （P 〉0.05）,the average lymph node cleaned was （14 ±6） vs.（19 ±6） （P 〉0.05）,the duration of the drainage was （47 ± 10） h vs.（161 ±41） h （P 〈0.05）,the duration of the urethral catheter was （92 ± 46） h vs.（175 ± 26） h （P 〈 0.05）,the postoperative hospital stays were （6.0 ± 0.8） d vs.（8.0 ±0.5） d （P 〈 0.05）.Except 1 case appeared poor mouth healing on the puncture outfit,there was no other complications in the laparoscope group.The incision of 1 case delayed healing about 2 cm on the left side and 1 case appeared the flap floating,which was healed after compression bandage and brake.Conclusion Laparoscopic inguinal lymphadenectomy is safe and feasible,These patients may have a shorter operation time,less blood loss,low complication rate,rapid recovery,a shorter postoperative hospital stay and other advantages,compared with the open operation,avoiding the skin flap necrosis and subcutaneous hematoma especially.

关 键 词：阴茎癌 腹腔镜 开放性 腹股沟淋巴结清扫术 

分 类 号：R737.27[医药卫生—肿瘤]