阴茎癌腹腔镜下腹股沟淋巴结清扫术与开放手术的临床疗效比较

目的比较阴茎癌腹腔镜腹股沟淋巴结清扫术与开放手术的临床疗效,探讨腹腔镜腹股沟淋巴结清扫术的可行性。方法回顾性分析84例因阴茎癌行腹股沟淋巴结清扫术患者资料。按淋巴结清扫方式将患者分为开放组和腹腔镜组。分析两组患者的术前基本资料、术中参数、术后并发症及疗效。结果腹腔镜组与开放组患者在年龄、临床肿瘤分期、淋巴结大小、手术时间、清扫淋巴结数量及术中失血量等方面差异无统计学意义(P>0.05);两组在术后住院时间、术后皮瓣坏死及切口感染发生率、术后淋巴瘘发生率等方面差异有统计学意义(P<0.05)。腹腔镜组2例复发,开放组3例复发,两组均无死亡病例,差异无统计学意义(P>0.05)。结论阴茎癌腹腔镜腹股沟淋巴结清扫术与开放手术相比,可获得相同的临床疗效,并且具有创伤小,术后并发症少等优点。

Clinical Effect of Laparoscopic Inguinal Lymph Node Dissection Versus Open Surgery for Penile Cancer

Objective To compare the clinical effect of laparoscopic inguinal lymph node dissection versus open surgery for penile cancer, and to explore the feasibility of laparoscopic inguinal lymph node dissection. Methods We retrospectively analyzed the data of 84 penile cancer patients who underwent inguinal lymph node dissection. Patients were divided into open group and laparoscopic group according to the surgical method of lymph node dissection. The preoperative data, intraoperative parameters, postoperative complications and efficacy of the two groups were analyzed. Results There was no statistically significant difference in age, clinical tumor stage, lymph node size, the operative time, the number of lymph nodes dissected or intraoperative blood loss between the laparoscopic group and the open group (P>0.05). But in terms of postoperative hospital stay, skin flap necrosis and postoperative incision infection rate, the incidence of postoperative lymphatic fistula, etc., there was statistical difference between the two groups (P<0.05). Postoperative follow-up was 3 months to 2 years, in which 2 patients in the laparoscopic group recurred, while 3 patients in the open group relapsed, with no death and no statistically significant difference between the both groups (P>0.05). Conclusion Compared with open surgery, laparoscopic inguinal lymphadenectomy could obtain the same clinical curative effect, but with less trauma and postoperative complications.