三孔同位入路法同期行腹腔镜下腹股沟及盆腔淋巴结清扫术治疗阴茎癌的初步探索
Preliminary exploration of three-holesame-site approach simultaneouslaparoscopic inguinal and pelvic lymphnodes dissection
刘树瀚 1谈宜傲 1黄涛 1王晶 1陶陶 1杨磊1
作者信息
- 1. 中国科学技术大学附属第一医院(安徽省立医院)西区,安徽省肿瘤医院泌尿肿瘤外科,合肥 230031
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摘要
目的:探讨三孔同位入路法同期行腹腔镜下腹股沟及盆腔淋巴结清扫术治疗阴茎癌伴局部淋巴结转移的可行性、优势及初步经验.方法:回顾性分析2020年1月至2023年1月我院施行三孔同位入路法同期行腹腔镜下腹股沟及盆腔淋巴结清扫术的患者5例,手术步骤主要包括:下腹部腹腔镜三孔建立,沿Scarpa筋膜行双侧腹腔镜腹股沟淋巴结清扫,经腹腔行双侧或单侧腹腔镜盆腔淋巴结清扫.记录手术及围手术期参数,并与开放腹股沟及盆腔淋巴结清扫术进行比较.结果:5例患者手术均顺利完成,手术时间(215.40±51.64)min,术中出血量中位数50 ml,单侧腹股沟淋巴结切除数量(11.10±2.42)个,单侧盆腔淋巴结切除数量(8.13±1.13)个,与开放手术相比,具有更少的术中出血量,更小的疼痛感、更短的腹股沟区皮下引流管留置时间和术后住院时间.结论:三孔同位入路法同期行腹腔镜下腹股沟及盆腔淋巴结清扫术是治疗阴茎癌局部淋巴结转移的可行且有效方案,在保证疗效显著的情况下,避免多次手术,减少患者的创伤和痛苦.
Abstract
Objective:To investigate the feasibility,advantages,and preliminary experience of simultaneous laparoscopic inguinal and pelvic lymph node dissection using a three-port ipsilateral approach in the treatment of penile cancer with regional lymph node metastasis.Methods:Five patients in our hospitalfrom January 2020 to January 2023were collected who underwent three-hole same-site approach simultaneous laparoscopicinguinal and pelvic lymph nodes dissection.The major surgical procedures include:establishment of three holesat the lower abdomen,bilateral laparoscopic inguinal lymph node dissection along the Scarpa fascia,and bilateral or unilateral transperitoneal laparo-scopic pelvic lymph node dissection.Operative and perioperative parameters were recorded and compared with those inthe open operation group.Results:The operative time was(215.40±51.64)min,the median of the intraoperative blood loss was 50 ml,the number of unilateral removed inguinal lymph nodes was(11.10±2.42),and the number of unilateral removed pelvic lymph nodes was(8.13±1.13).This operation had less intraoperative blood loss,less pain index,shorter inguinal drainage tube retention time and postoperative hospital stay compared with open operation.Conclusion:Simultaneous laparoscopic inguinal and pelvic lymph node dissection using a three-port ipsilateral ap-proach is a feasible and effective method for treating penile cancer with regional lymph node metastasis.This approach ensures significant therapeutic efficacy while avoiding multiple surgeries,thereby reducing trauma and discomfort for the patient.
关键词
腹股沟淋巴结清扫/盆腔淋巴结清扫/腹腔镜/阴茎癌Key words
inguinal lymph node dissection/pelvic lymph node dissection/laparoscopy/penile cancer引用本文复制引用
出版年
2024
NETL
NSTL
万方数据