腹腔镜与开放阴茎癌腹股沟淋巴结清扫术疗效比较  

Comparison of laparoscopic and open surgery for penile cancer inguinal lymph node dissection

作　　者：邱新凯 燕东亮[1,2] 梅延辉[1] 苏庆国[1] 张冰[1] 曹景源[1] 牛文杰[1] 刘少青[1] 尹洪山[1] 

机构地区：[1]滨州医学院附属医院泌尿外科,滨州256603 [2]上海交通大学附属上海第六人民医院泌尿外科

出　　处：《中国男科学杂志》2016年第9期39-43,共5页Chinese Journal of Andrology

基　　金：滨州市科技发展计划项目(2014ZC0157);滨州医学院科技计划项目(BY2014KJ38)

摘　　要：目的比较腹腔镜与开放阴茎癌腹股沟淋巴结清扫术临床疗效。方法回顾性分析我院自2013年4月至2016年3月行腹腔镜手术（laparoscopic surgery，LS）和开放手术（open surgery，OS）共28例患者的资料，其中LS组13例，OS组15例。对两组患者的术前基本资料、围术期数据、术后并发症情况进行对比分析。结果LS组较OS组具有术中出血量少，术后引流管留置时间短，术后住院时间短，术后皮瓣坏死率低的特点。LS组较OS组手术时间长，差异（P=0.001），两组患者在淋巴结清扫个数（P=0.348）、淋巴结阳性率（P=0.788）以及术后切口感染（P=0.640）、淋巴囊肿（P=0．524）、淋巴漏（P=0.918）、血清肿（P=0.348）及下肢水肿（P=0．763）方面差异均无统计学意义。13例患者随访6-41个月，平均22个月，未出现复发和转移。结论腹腔镜下腹股沟淋巴结清扫术同开放手术相比，安全可行，治疗效果肯定，具有术中出血量少，住院时间短，术后皮瓣坏死率低等优点。Objeotive To compare the clinical efficacy of laparoscopic surgery （LS） and open surgery （OS） for penile cancer inguinal lymph node dissection. Methods Twenty-eight patients with penile cancer who underwent LS or OS with laparoscopic bilateral inguinal lymph node dissection from April 2013 to March 2016 were retrospectively reviewed, including 13 cases of LS and 15 cases of OS. The demographic parameters of patients, perioperative data, postoperative complication and oncology results were recorded and evaluated. Results The LS group had lower blood loss （P=0.000） , shorter drainage tube indwelling time （P=0.000） , shorter hospital stay （P=0.011）, less skin necrosis （P=0.029）, more surgical time （P=0.001） compared with the OS group. There were no differences in the mean number of dissected lymph nodes （P=0.348）, and lymph node positive rate （P=0.788） between the two groups. There were no differences in term of wound infection （P=0.640）, lymphocele （P=0.524）, lymphatic leakage （P=0.918）, hematoncus （P=0.348）, lower limb edema （P=0.763）. During 22 months following-up （range from 6 to 41 mouths）, the all patients had no signs of recurrence and metastasis. Conclusion Laparoscopic surgery shows some advantages in reduction of skin necrosis, wound healing time, and surgery hemorrhage over open surgery. It is same efficiency as open surgery.

关 键 词：阴茎肿瘤 腹腔镜检查 淋巴结切除术 

分 类 号：R737.27[医药卫生—肿瘤]