阴茎癌的内镜下淋巴结切除术
Endoscopic lymphadenectomy for penile carcinoma.
作者信息
Sotelo Rene, Sánchez-Salas Rafael, Carmona Oswaldo, Garcia Alejandro, Mariano Mirandolino, Neiva Gilvan, Trujillo Gustavo, Novoa John, Cornejo Francisco, Finelli Antonio
机构信息
Section of Laparoscopic and Minimally Invasive Surgery, Department of Urology, La Floresta Medical Institute, Caracas, Venezuela.
出版信息
J Endourol. 2007 Apr;21(4):364-7; discussion 367. doi: 10.1089/end.2007.9971.
BACKGROUND AND PURPOSE
Groin dissection remains the gold standard for the treatment of penile carcinoma that has metastasized to the inguinal lymph nodes. However, it is associated with wound-related complications. Modified groin dissection offers a less-radical approach without compromising oncologic outcomes. We present our technique for endoscopic lymphadenectomy for penile carcinoma (ELPC).
PATIENTS AND METHODS
Eight patients with clinical stage T(2) N(0-3)M(0) penile carcinoma underwent ELPC. Preoperative Doppler ultrasound mapping of the inguinal lymph nodes and the saphenous vein was performed.
RESULTS
Fourteen lymphadenectomies, including superficial with or without deep inguinal and pelvic-node dissection, were completed in eight patients. The median operative time was 91 minutes (range 50-150 minutes), and the mean number of nodes removed was 9 (range 4-15). No perioperative complications occurred. Lymphoceles developed in three groins (23%). No wound-related complications were seen.
CONCLUSIONS
The ELPC is a safe and feasible technique that appears to diminish the wound-related complications associated with the standard open approach.
背景与目的
腹股沟淋巴结清扫术仍是治疗已转移至腹股沟淋巴结的阴茎癌的金标准。然而，它与伤口相关并发症有关。改良腹股沟淋巴结清扫术提供了一种创伤较小的方法，同时不影响肿瘤学治疗效果。我们介绍我们的阴茎癌内镜下淋巴结清扫术（ELPC）技术。
患者与方法
8例临床分期为T(2)N(0 - 3)M(0)的阴茎癌患者接受了ELPC。术前对腹股沟淋巴结和大隐静脉进行多普勒超声定位。
结果
8例患者共完成14例淋巴结清扫术，包括浅表腹股沟淋巴结清扫（伴或不伴深部腹股沟及盆腔淋巴结清扫）。中位手术时间为91分钟（范围50 - 150分钟），平均切除淋巴结数为9个（范围4 - 15个）。未发生围手术期并发症。3个腹股沟区出现淋巴囊肿（23%）。未观察到与伤口相关的并发症。
结论
ELPC是一种安全可行的技术，似乎能减少与标准开放手术方法相关的伤口并发症。
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