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目的比较阴茎癌腹腔镜下与腹股沟皮桥手术在腹股沟淋巴结清扫中的临床效果及并发症。方法回顾性分析2009年1月至2015年5月75例阴茎癌患者行双侧腹股沟淋巴结清扫的临床资料。所有患者均行阴茎原发灶部分切除或全部切除。其中22例患者行腹腔镜双侧腹股沟淋巴结清扫术(腹腔镜组),53例患者使用腹股沟皮桥行双侧腹股沟淋巴结清扫术(腹股沟皮桥组)。对两组患者的术中出血量、手术时间、术后引流管拔除时间、平均住院时间、切除淋巴结数量及并发症等进行比较。结果腹腔镜组与腹股沟皮桥组相比,手术时间分别为(100.73±7.97)min、(119.85±7.37)min;术中出血量分别为(29.09±4.94)mL、(51.32±5.83)mL;平均住院时间分别为(9.27±3.72)d、(11.53±4.29)d;术后拔除引流管时间分别为(8.00±2.81)d、(9.53±2.23)d,差异均有统计学意义(P<0.05)。术中淋巴结清扫数量分别为(12.95±9.53)枚、(13.98±8.99)枚,差异无统计学意义(P>0.05)。腹腔镜组并发症发生率为22.73%,腹股沟皮桥组并发症发生率为47.17%,差异有统计学意义(P<0.05)。结论与腹股沟皮桥手术相比,腹腔镜下进行腹股沟淋巴结清扫有减少术中出血量、缩短手术时间、缩短住院时间、降低手术并发症等优点。
Objective To compare the clinical effects and complications of laparoscopic and inguinal skin bridge surgery in inguinal lymph node dissection. Methods The clinical data of 75 patients with penile cancer who underwent bilateral inguinal lymph node dissection were analyzed retrospectively from January 2009 to May 2015. All patients underwent primary resection of the penis or partial resection. Twenty-two patients underwent laparoscopic bilateral inguinal lymph node dissection (laparoscopic group) and 53 patients underwent bilateral inguinal lymph node dissection (inguinal skin bridge group) with inguinal skin grafts. The intraoperative blood loss, operation time, drainage time of postoperative drainage tube, average length of hospital stay, number of resected lymph nodes and complications were compared between the two groups. Results The operative time was (100.73 ± 7.97) min and (119.85 ± 7.37) min respectively in the laparoscopic group and the inguinal skin graft group. The intraoperative blood loss was (29.09 ± 4.94) mL and (51.32 ± 5.83) mL, respectively. The average length of hospital stay was (9.27 ± 3.72) d and (11.53 ± 4.29) d, respectively. The drainage time of the drainage tube after operation was (8.00 ± 2.81) d and (9.53 ± 2.23) days respectively, with significant differences between the two groups (P < 0.05). The number of lymph node dissection was (12.95 ± 9.53) and (13.98 ± 8.99) pieces respectively, with no significant difference (P> 0.05). The incidence of complications in laparoscopic group was 22.73%, the incidence of complications in inguinal skin graft group was 47.17%, the difference was statistically significant (P <0.05). Conclusion Compared with the inguinal skin bridge operation, laparoscopic inguinal lymph node dissection has the advantages of reducing intraoperative blood loss, shortening the operation time, shortening the length of hospital stay, and reducing the complications of operation.