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机器人辅助同步双侧根治性腹股沟淋巴结清扫术联合机器人双侧盆腔淋巴结清扫术:一项可行性研究

Robot-Assisted Simultaneous Bilateral Radical Inguinal Lymphadenectomy Along with Robotic Bilateral Pelvic Lymphadenectomy: A Feasibility Study.

作者信息

Ahlawat Rajesh, Khera Rakesh, Gautam Gagan, Kumar Abhay

机构信息

1 Department of Urology, Renal Transplant & Robotics, Institute of Kidney and Urology , Medanta-The Medicity, Gurgaon, India .

出版信息

J Laparoendosc Adv Surg Tech A. 2016 Nov;26(11):845-849. doi: 10.1089/lap.2015.0611. Epub 2016 May 31.

Abstract

INTRODUCTION

To report the surgical technique, procedure outcomes, and feasibility of robot-assisted simultaneous bilateral radical inguinal with bilateral pelvic lymphadenectomy.

MATERIALS AND METHODS

Three consecutive patients of penile and urethral carcinoma with palpable inguinal lymphadenopathy who underwent robot-assisted simultaneous bilateral radical inguinal with bilateral pelvic lymphadenectomy in our institution from May 2013 to October 2015 were included in the study. Surgical technique is described and feasibility of the procedure is assessed.

RESULTS

Three patients aged 58, 76, and 35 years underwent robot-assisted simultaneous bilateral radical inguinal with bilateral pelvic lymphadenectomy with a mean operative duration of 453.33 minutes (range 420-490 minutes). Average blood loss was 66.66 mL (range 50-80 mL) and mean time to removal of last drain was 44.66 days (range 28-72 days). Mean lymph node yield in left inguinal region, right inguinal region, left pelvic region, and right pelvic region was 18, 14.6, 13.3, and 16.6, respectively. The perioperative period was uneventful. No skin flap-related complications were seen. One patient suffered lymphocele postoperatively, which was managed successfully with needle aspiration. One patient developed lung metastasis in follow-up and none of them had local recurrence.

CONCLUSION

Robot-assisted simultaneous bilateral radical inguinal with bilateral pelvic lymphadenectomy is feasible, safe, and may result in decreased morbidity compared to conventional open lymphadenectomy.

摘要

引言

报告机器人辅助下同时进行双侧根治性腹股沟淋巴结清扫术及双侧盆腔淋巴结清扫术的手术技术、手术结果及可行性。

材料与方法

纳入2013年5月至2015年10月在我院接受机器人辅助下同时进行双侧根治性腹股沟淋巴结清扫术及双侧盆腔淋巴结清扫术的3例阴茎癌和尿道癌伴可触及腹股沟淋巴结肿大的连续患者。描述手术技术并评估该手术的可行性。

结果

3例患者年龄分别为58岁、76岁和35岁,接受了机器人辅助下同时进行双侧根治性腹股沟淋巴结清扫术及双侧盆腔淋巴结清扫术,平均手术时间为453.33分钟(范围420 - 490分钟)。平均失血量为66.66 mL(范围50 - 80 mL),最后一根引流管拔除的平均时间为44.66天(范围28 - 72天)。左腹股沟区、右腹股沟区、左盆腔区和右盆腔区的平均淋巴结收获量分别为18个、14.6个、13.3个和16.6个。围手术期过程顺利。未观察到与皮瓣相关的并发症。1例患者术后发生淋巴囊肿,经针吸成功处理。1例患者在随访中出现肺转移,均无局部复发。

结论

机器人辅助下同时进行双侧根治性腹股沟淋巴结清扫术及双侧盆腔淋巴结清扫术是可行、安全的,与传统开放淋巴结清扫术相比,可能会降低发病率。

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