腹腔镜联合开放腹股沟淋巴结清扫在黑色素瘤淋巴结转移治疗中的应用  

Application of Aparoscopic Pelvic Lymph Node Dissection Combined with Inguinal Lymph Node Dissection in The Treatment of Metastatic Melanoma Lymph Node

作　　者：陈昌江[1] 杨春康[1] 吴贤毅[1] 官申[1] 简锦亮 谢明明 CHEN Changjiang;YANG Chunkang;WU Xianyi;GUAN Shen;JIAN Jinliang;XIE Mingming(Department of Surgical Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou 350014, China)

机构地区：[1]福建医科大学附属肿瘤医院,福建省肿瘤医院胃肠肿瘤外科,福州350014

出　　处：《福建医科大学学报》2021年第5期425-428,共4页Journal of Fujian Medical University

摘　　要：目的探讨腹腔镜下盆腔淋巴结清扫联合腹股沟淋巴结清扫术在黑色素瘤淋巴结转移治疗中的应用。方法回顾性分析15例同侧盆腔髂血管旁和(或)腹股沟区淋巴结转移的黑色素瘤患者,原发病灶均来源于同侧下肢。手术方式为先腹腔镜下行盆腔淋巴结清扫再转开放下完成腹股沟区淋巴结清扫。结果15例手术均顺利完成,手术时间(177.2±28.17)min,术中出血量(51.67±25.14)mL,平均术后下床活动时间(4.00±1.26)d,平均术后住院时间(8.00±1.10)d。术后并发下肢血栓1例、腹股沟区淋巴漏1例、肺部感染1例。经病理检验均证实有髂血管旁淋巴结和(或)腹股沟区淋巴结转移。结论腹腔镜下盆腔淋巴结清扫联合腹股沟淋巴结清扫术是髂腹股沟淋巴结黑色素瘤转移治疗中明确可行的手术方式,该术式淋巴结清扫范围广、清扫彻底,手术创伤较小、恢复快、并发症少。Objective To investigate the application of laparoscopic pelvic lymph node dissection combined with inguinal lymph node dissection in the treatment of metastatic melanoma lymph node.Methods Retrospective analysis was performed on 15 patients with ipsilateral pelvic iliac paravascular and/or inguinal metastatic melanoma lymph node admitted to Fujian Cancer Hospital from August 2017 to August 2020.The primary lesions were all from ipsilateral lower extremities.The operation was performed by laparoscopic pelvic lymph node dissection and then laparoscopic pelvic lymph node dissection in the inguinal region.Results All the 15 operations were completed successfully.The mean operative time was(177.2±28.17)minutes,the mean intraoperative blood loss was(51.67±25.14)mL,the mean postoperative activity time was(4.00±1.26)days,and the mean postoperative hospitalization time was(8.00±1.10)days.There was 1 case of lower limb thrombosis,1 case of inguinal lymphatic leakage and 1 case of pulmonary infection.There were no other complications.Pathological examination confirmed periiliac lymph node and/or inguinal lymph node metastasis.Conclusion Laparoscopic pelvic lymph node dissection combined with inguinal lymph node dissection is a clear and feasible surgical method for the treatment of ilioinguinal metastatic melanoma lymph node.This operation has a wide range of lymph node dissection,complete dissection,less trauma,quick recovery,less complications.

关 键 词：腹腔镜下盆腔淋巴结清扫联合腹股沟淋巴结清扫 黑色素瘤 淋巴结转移 

分 类 号：R73[医药卫生—肿瘤]