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目的:探讨腹腔镜下腹膜后淋巴结清扫术治疗临床Ⅰ期睾丸非精原细胞肿瘤的临床经验及疗效。方法:回顾性分析2008年10月～2011年6月7例睾丸非精原细胞癌的临床资料,其中左侧4例,右侧3例,平均年龄(34±11)岁,胚胎癌5例,混合性生殖细胞肿瘤2例。术前临床分期均为I期;7例患者均在根治性睾丸切除术后1周行腹腔镜下腹膜后淋巴结清扫术。结果:所有手术均顺利完成,无中转开放,围手术期无严重并发症。平均手术时(172±35)min,术中平均出血量(43±14)ml,平均切除淋巴结(12±3)个,淋巴结阳性患者2例。术后平均住院时间(6±2)d,术后平均随访(25±10)个月,所有患者术后射精功能正常,肿瘤无局部复发及远处转移。结论:腹腔镜下腹膜后淋巴结清扫术安全、有效,具有创伤小、恢复快等优点,可作为明确诊断和治疗临床Ⅰ期睾丸非精原细胞肿瘤的首选方法。
Objective: To investigate the clinical experience and efficacy of laparoscopic retroperitoneal lymph node dissection in the treatment of stage Ⅰ testicular non-seminoma. Methods: The clinical data of 7 cases of testicular non-seminoma from October 2008 to June 2011 were retrospectively analyzed. There were 4 cases on the left side and 3 cases on the right side. The mean age was 34 ± 11 years old and 5 cases were embryonal carcinoma , Mixed germ cell tumors in 2 cases. The preoperative clinical stage was stage I; all 7 patients underwent laparoscopic retroperitoneal lymph node dissection 1 week after radical orchiectomy. Results: All the operations were successfully completed, no transfer to open, no serious perioperative complications. The mean operative time was (172 ± 35) min, mean intraoperative blood loss was (43 ± 14) ml, average number of resected lymph nodes (12 ± 3) and lymph node positive patients (2). The average postoperative hospital stay was (6 ± 2) days. The average follow-up time was (25 ± 10) months. All patients had normal postoperative ejaculation and no local recurrence and distant metastasis. Conclusion: Laparoscopic retroperitoneal lymphadenectomy is safe and effective, with less trauma and faster recovery. It can be used as the first choice for the diagnosis and treatment of stage Ⅰ testicular nonseminomatous neoplasms.