改良皮瓣与沟槽负压引流技术在阴茎癌腹股沟淋巴结清扫中的应用  

Clinical efficacy of modified flap and grooved negative pressure drain technique in inguinal lymph node dissection of penile carcinoma

作　　者：邓旺龙[1] 孙建明[1] 邹义华[1] 张威[1] 邓毕华[1] 陈晓峰[1] Deng Wanglong;Sun Jianming;Zou Yihua;Zhang Wei;Deng Bihua;Chen Xiaofeng(Department of Urology,The First People’s Hospital of Chenzhou,Chenzhou 423000,Hunan,China)

机构地区：[1]郴州市第一人民医院泌尿外科,湖南郴州423000

出　　处：《中国男科学杂志》2023年第3期76-79,85,共5页Chinese Journal of Andrology

摘　　要：目的 探讨通过改良皮瓣及沟槽负压引流技术行腹股沟淋巴结清扫在阴茎癌患者中的应用,观察其临床疗效。方法 回顾分析我科自2018年3月至2022年3月收治的阴茎癌行双侧腹股沟淋巴结清扫术的病人,共31人62侧,术中采用S形切口及精准解剖,皮瓣浅筋膜浅层得到完整保留,皮瓣用丝线固定于其下方深筋膜,平行切口切除切口两侧皮瓣边缘全层宽约5 mm,并行皮内缝合切口,术后采用沟槽负压引流方式。结果 31例患者完成62侧手术,随访时间4~51个月,淋巴漏4侧次(6.5%),切口感染2侧次(3.2%),下肢或阴囊水肿7侧次(11.3%),皮缘坏死1侧次(1.6%),未发生并发症51侧(82.3%),术后住院时间8~21 d [(12.9±2.9)d],平均留置引流管时间8~18 d [(11.2±2.6)d]。结论 改良皮瓣技术的腹股沟淋巴结清扫结合沟槽负压引流对阴茎癌的治疗具有明显优势,有利于切口愈合,减少并发症的发生率。Objective To investigate clinical efficacy of modified flap and grooved negative pressure drain tube technique in inguinal lymph node dissection of penile cancer.Methods Clinical data of 31 patients with penile cancer,who underwent bilateral inguinal lymphadenectomy in our department from March 2018 to March 2022,were retrospectively analyzed.For these patients,S⁃shaped incision and precise anatomy were adopted during the operation.The skin flap was fixed in the deep fascia under the flap with non⁃absorbable sutures.The full⁃thickness skin flap edge on both sides of the incision was removed about 5 mm wide,and the incision was sutured intradermically,and grooved negative pressure drain tube was used after operation.Results The patients all underwent 62 sides of operation and were followed up for 4⁃51 months.There were 4 sides of lymphatic leakage(6.5%),2 sides of incision infection(3.2%),7 sides of lower limb or scrotal edema(11.3%),1 side of skin margin necrosis(1.6%),and 51 sides of no complications(82.3%).The duration of postoperative hospitalization was 8⁃21 d[(12.9±2.9)d],and the mean duration of drainage tube indentation was 8⁃18 d[(11.2±2.6)d].Conclusion The improved flap technique of inguinal lymph node dissection combined with negative pressure drainage has obvious advantages in the treatment of penile cancer,which is conducive to incision healing and reduces the incidence of complications.

关 键 词：阴茎肿瘤 腹股沟淋巴清扫术 外科皮瓣 负压引流 

分 类 号：R737.26[医药卫生—肿瘤] R699.8[医药卫生—临床医学]