Department of Urology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China.
Department of Urology, Henan Provincial People's Hospital, Zhengzhou, Henan, China.
BMC Surg. 2022 Apr 9;22(1):138. doi: 10.1186/s12893-022-01582-3.
Inguinal lymphadenectomy (iLAD) is effective for penile carcinoma treatment, but usually results in many complications. This study aims to clinically evaluate the feasibility and clinical significance of a laparoscopic radical iLAD approach partly preserving great saphenous vein branches for penile carcinoma patients.
A total of 48 patients with penile cancer who underwent laparoscopic radical iLAD with retention of the great saphenous vein in Henan Cancer Hospital from 2012 Jan to 2020 Dec were included in this study. Sixteen penile carcinoma patients who underwent laparoscopic radical iLAD preserving parts of superficial branches of the great saphenous vein were identified as the sparing group, and the matched 32 patients who incised those branches were identified as control group. This new procedure was performed by laparoscopy, preserving parts of superficial branches of the great saphenous vein, superficial lateral and medial femoral veins. Clinicopathological features and perioperative variables were recorded. Postoperative complications, including skin flap necrosis, lymphorrhagia, and lower extremity edema were analyzed retrospectively.
We found that the operative time of the sparing group is significantly longer than the control group (p = 0.011). There was no statistical difference in intraoperative blood loss, the lymph node number per side, average time to remove the drainage tube and postoperative hospital stay between the two groups. Compared to the control group, the sparing group showed a significantly decreased incidence of lower extremity edema (p = 0.018). The preservation of parts of superficial branches of the great saphenous vein was mainly decreased the incidence of edema below ankle (p = 0.034).
This study demonstrated that the iLAD with preserving parts of superficial branches of the great saphenous vein, with a decreased incidence of postoperative complications, is a safe and feasible approach for penile cancer.
腹股沟淋巴结清扫术（iLAD）对阴茎癌的治疗有效，但通常会导致许多并发症。本研究旨在临床评估部分保留大隐静脉分支的腹腔镜根治性 iLAD 方法治疗阴茎癌患者的可行性和临床意义。
回顾性分析 2012 年 1 月至 2020 年 12 月河南省肿瘤医院 48 例行腹腔镜根治性 iLAD 保留大隐静脉的阴茎癌患者的临床资料。将保留大隐静脉浅支的 16 例阴茎癌患者分为保留组，同期行大隐静脉浅支部分结扎的 32 例患者为对照组。所有患者均行腹腔镜手术，保留大隐静脉浅支、股浅外侧和股浅内侧静脉。记录患者的临床病理特征和围手术期变量。回顾性分析术后并发症，包括皮瓣坏死、淋巴漏和下肢水肿。
保留组的手术时间明显长于对照组（p=0.011）。两组术中出血量、淋巴结清扫数、引流管拔除时间和术后住院时间比较差异无统计学意义。与对照组相比，保留组下肢水肿发生率明显降低（p=0.018）。保留大隐静脉浅支主要降低了踝以下水肿的发生率（p=0.034）。
该研究表明，保留大隐静脉浅支的 iLAD 可降低术后并发症的发生率，是一种安全可行的阴茎癌治疗方法。
