英国三级皮肤癌服务中微创腹股沟淋巴结清扫术的介绍：初步经验和结果。
Introducing minimally invasive inguinal lymph node dissection in a UK tertiary skin cancer service: Initial experience & outcomes.
机构信息
Department of Plastic & Reconstructive Surgery, Colney Lane, Norwich NR4 7UY, UK.
Department of Urology, Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, UK.
出版信息
J Plast Reconstr Aesthet Surg. 2022 Feb;75(2):737-742. doi: 10.1016/j.bjps.2021.09.054. Epub 2021 Oct 22.
AIMS
We report the first UK case series of minimally invasive inguinal lymphadenectomy (MILND) for patients with metastatic cutaneous pathology.
METHODS
This was a retrospective, single-centre, single-surgeon cohort study. Twenty-one patients who underwent MILND from May 2015 to February 2019 were included. Demographic data, disease burden, and surgical quality assurance parameters were analysed.
RESULTS
Median age was 69 (IQR: 58-76) with 14 women (66%) and 7 men (33%). Eighteen (85%) patients had melanoma with the rest having other skin malignancies. The median number of nodes resected was eight (IQR:6-11) and the median N-ratio was 0.18 [0.05-1.00]. The median surgical time for the procedure was 180 minutes (IQR: 147-225) Seven (33%) patients had complications--three trivial and four (19%) grade IIIB. Only one case (the first) was converted to an open procedure.
CONCLUSIONS
We report the first UK series of MILND in a cutaneous oncology service. Our results show that MILND is a safe technique that can be introduced into a busy NHS practice with a structured training program, with surgical quality assurance outcomes identical to open inguinal lymphadenectomy. Our learning curve was similar to previously published data.
目的
我们报告了英国首例微创腹股沟淋巴结切除术（MILND）治疗转移性皮肤病变患者的病例系列。
方法
这是一项回顾性、单中心、单外科医生队列研究。纳入了 2015 年 5 月至 2019 年 2 月期间接受 MILND 的 21 名患者。分析了人口统计学数据、疾病负担和手术质量保证参数。
结果
中位年龄为 69 岁（IQR：58-76），女性 14 例（66%），男性 7 例（33%）。18 例（85%）患者患有黑色素瘤，其余患者患有其他皮肤恶性肿瘤。切除的淋巴结中位数为 8 个（IQR：6-11），N 比中位数为 0.18[0.05-1.00]。该手术的中位手术时间为 180 分钟（IQR：147-225），7 例（33%）患者出现并发症——3 例为轻微并发症，4 例（19%）为 IIIB 级。仅 1 例（首例）转为开放性手术。
结论
我们报告了英国首例皮肤肿瘤学服务中进行的 MILND 系列研究。我们的结果表明，MILND 是一种安全的技术，可以在有结构化培训计划的繁忙 NHS 实践中引入，手术质量保证结果与开放式腹股沟淋巴结切除术相同。我们的学习曲线与之前发表的数据相似。
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