减少阴茎癌腹股沟淋巴结清扫术并发症的临床技巧研究(附30例报告)

目的探讨减少阴茎癌腹股沟淋巴结清扫术后并发症的手术操作技巧及其效果。方法回顾性分析2000年1月至2011年10月间收治的30例行改进根治性双侧腹股沟淋巴结清扫术的阴茎癌患者的临床资料。30例共60侧行腹股沟淋巴结清扫,其中29例为阴茎癌手术时同期淋巴清扫。清扫范围足够,淋巴结清除彻底,改进技术包括设计腹股沟"S"形皮肤切口、通过确认Campas筋膜的膜性解剖标志层来分离皮瓣、皮瓣边缘缝线牵引、完整保留阔筋膜、尽可能保留阴部外浅静脉、术后良好的引流及加压包扎。结果 30例患者随访5～128个月,共发生并发症15侧次(25.0%),其中轻度皮瓣坏死4侧次(6.7%)、切口感染3侧次(5.0%)、淋巴水肿8侧次(13.3%),无下肢深静脉血栓。结论通过改进腹股沟淋巴结清扫术可有效减少阴茎癌患者腹股沟淋巴结清扫术后并发症。

Clinical investigation on improved technology reducing the postoperative complication of inguinal lymphadenectomy for penile cancer(30 cases)

Objective To explore the operation technique skills and efficacy of inguinal lymph- adenectomy for penile cancer in order to reducing the complication. Methods By a retrospective a- nalysis of 30 cases of the patients suffered from penile cancer and having received modified radical in- guinal lymph node dissection of 60 sides from January 2000 to October 2011. In those cases, dissec- ting range was enough, lymph nodes were removed completely through technology of S-shaped inci- sion, the film anatomical landmark separation flap suture traction intact fascia lata, good postopera- tive drainage and pressure dressing. Results 30 cases were followed up from 5 to 128 months. 15 sides （25.0 M ） have complication, among which there are 4 sides （6.7 ~） with mild skin flap necro- sis and there are 3 sides （5.0%） with wound infection, 8 sides （la. aM） has lymphedema. No lower limb deep venous thrombosis was found. Conclusions The postoperative complication of inguinal lymphadenectomy for penile cancer can he reduced significantly by modified radical inguinal lymph node dissection.