阴茎癌腹股沟淋巴结清扫术中保留大隐静脉能否减少术后并发症的系统评价  

Systematic review of whether preserving the great saphenous vein can reduce the postoperative complications in inguinal lymphadenectomy for penile cancer

作　　者：吴健勇[1] 唐勇[1] 易贤林[1] 陆浩源[1] 彭新庆 李秀宁[1] 高超[1] 刘翰楠 庞波[1] 李宇虹[1] 陈玉[1] WU Jian-yong;TANG Yong;YI Xian-lin;LU Hao-yuan;PENG Xin-qing;LI Xiu-ning;GAO Chao;LIU Han-nan;PANG Bo;LI Yu-hong;CHEN Yu(Department of Urology, Cancer Hospital of Guangxi Medical University, Nanning 530021, China)

机构地区：[1]广西医科大学附属肿瘤医院泌尿外科,南宁530021 [2]广西医科大学附属武鸣医院泌尿外科

出　　处：《现代泌尿生殖肿瘤杂志》2017年第4期210-216,共7页Journal of Contemporary Urologic and Reproductive Oncology

基　　金：广西医疗卫生重点科研课题(重2012093);广西科学研究与技术开发计划项目课题(桂科攻1355005-3-11)

摘　　要：目的探讨阴茎癌腹股沟淋巴结清扫术中保留大隐静脉能否减少术后并发症的发生。方法在中国知网、万方、维普、中国生物医学文献数据库、Web of Science、PubMed、Cochrane Library等电子数据库中进行阴茎癌腹股沟淋巴结清扫术相关文献检索,检索时限从建库至2017年4月1日。由2名研究者独立交叉阅读筛选及提取文献信息,第3名研究员对结果进行对比核查。结果纳入符合标准的文献共39篇。开放腹股沟淋巴结清扫术组12篇(其中单纯保留大隐静脉组7篇,单纯切除大隐静脉组2篇,有3篇文献同时对比保留大隐静脉组及切除大隐静脉组),腹腔镜下腹股沟淋巴结清扫术组27篇(其中单纯保留大隐静脉组8篇,单纯切除大隐静脉组18篇,有1篇文献同时对比保留大隐静脉组及切除大隐静脉组)。保留大隐静脉/不保留大隐静脉的开放腹股沟淋巴结清扫术病例的切口感染率、皮瓣坏死率、淋巴肿发生率、血清肿发生率、下肢水肿发生率差异均有统计学意义(P<0.05)。保留大隐静脉/不保留大隐静脉的腹腔镜下腹股沟淋巴结清扫术病例的切口感染率、血清肿发生率、下肢水肿发生率差异亦有统计学意义(P<0.05)。结论无论在开放或是腹腔镜腹股沟淋巴结清扫术中,保留大隐静脉相对于不保留者能显著减少术后并发症的发生。Objective To explore whether preserving the great saphenous vein can reduce the postoperative complications in inguinal lymphadenectomy for penile cancer.MethodsThe literature of penile cancer with inguinal lymph node dissection was searched by electronic databases such as Chinese Knowledge Network,Wanfang,Weipu,Chinese Biomedical Literature Database,Web of Science,PubMed and Cochrane Library.Search time ranged from the building to April1,2017.Two researchers independently crossed the screening and extracted the literature,and the third researcher conducted a comparison of the results.ResultsA total of39manuscripts were included in the standard.There were12manuscripts which involved open groin lymph node dissection group.In these groups,there were7manuscripts which involved retaining the great saphenous vein and2manuscripts which involved resection of the great saphenous vein.There were3manuscripts which involved both retaining the great saphenous vein and resection of the great saphenous vein.There were27manuscripts which involved laparoscopic inguinal lymph node dissection group.In those groups,there were8manuscripts which involved retaining the great saphenous vein and18manuscripts which involved resection of the great saphenous vein.Only one manuscript involved both retaining the great saphenous vein and resection of the great saphenous vein.In the case of open inguinal lymph node dissection,there was significant statistical difference in the rate of incision infection,the rate of flap necrosis,the incidence of lymphedema,the rate of seroma and the incidence of lower extremity edema between patients with retaining the great saphenous vein and without retaining the great saphenous vein(P<0.05).In the case of laparoscopic inguinal lymph node dissection,there was also statistically significant difference in the rate of incision infection,the incidence of seroma,and the incidence of lower extremity edema(P<0.05).ConclusionsBoth in open and laparoscopic inguinal lymph node dissection,retention of the great sapheno

关 键 词：阴茎肿瘤 腹股沟淋巴结清扫术 大隐静脉 并发症 

分 类 号：R737.27[医药卫生—肿瘤]