阴茎癌腹腔镜下与开放腹股沟淋巴结清扫手术效果比较

摘要

目的 比较阴茎癌腹腔镜腹股沟淋巴结清扫术与开放腹股沟淋巴结清扫术的并发症及疗效.方法 回顾性分析2014年9月至2015年9月共19例行单侧腹股沟淋巴结清扫患者的临床资料.年龄38～69岁,平均55.2岁.其中9例行腹腔镜手术,10例行开放手术.对两组患者手术时间、术中出血量、术后并发症发生率、术后住院时间、术后拆线时间等进行分析比较.结果 腹腔镜组与开放组相比,手术时间[(151.11±33.27) min vs.(156.81±42.14) rmin]、术中淋巴结清扫数量[(7.00±2.60)个vs.(11.73±6.10)个]、术后住院天数[(8.63±1.41)d vs.(9.69±2.39)d]差异均无统计学意义(P＞ 0.05);而术中出血量[(29.44±17.40) ml vs.(57.73±26.96) ml]、术后ClevienⅡ级并发症的发生率(0 vs.30％,P＜0.05)、术后拔除引流管时间[(7.33±2.06)d vs.(12.18 ±2.71)d)]、术后伤口拆线时间[(7.33 ±1.12)d vs.(12.45±2.30)d]要明显少于开放手术组(P＜0.05).结论 与开放手术相比,腹腔镜手术组可以获得相同的疗效,并且具有降低并发症发生率、伤口恢复较快、减少术中出血等优点.%Objective To compare the efficiency and complications of laparoscopic and open inguinal lymphadenectomy.Method Nineteen patients underwent one side inguinal lymphadenectomy were collected for the study from September 2014 to September 2015.The patients' average age was 55.2 years (ranging 38 to 69 years).Nine patients underwent laparoscopic surgery,and 10 patients underwent open surgery.Operation time,hemorrhage,complications,hospital stay,and wound healing time were compared between the two groups.Result Surgical time[(151.11 ±33.27)min vs.(156.81 ±42.14)min],number of lymph node resected [(7.00 ± 2.60) vs.(11.73 ± 6.10)],and hospital stay [(8.63 ± 1.41) d vs.(9.69 ± 2.39) d] showed no statistic difference between laparoscopic surgery group and open surgery group(P ＞ 0.05).However,hemorrhage [(29.44 ± 17.40) ml vs.(57.73 ± 26.96) ml],drainage time [(7.33 ± 2.06)d vs.(12.18 ±2.71)d],Clevien grade Ⅱ complications (0 vs.30％),and wound healing time [(7.33-± 1.12)vs.(12.45 ± 2.30)] were significantly reduced in laparoscopic surgery group compared with open surgery group (P ＜ 0.05).Conclusions Compared with open surgery,laparoscopic surgery could achieve the same efficiency,and had the advantage of reduction of complications,wound healing time as well as in-surgery hemorrhage.