Sakakibara N, Koyama T, Shinno Y, Morita K, Nonomura K, Sasaki Y, Tabata T, Kubota M
Department of Urology, Kushiro Municipal General Hospital.
Nihon Hinyokika Gakkai Zasshi. 1994 Sep;85(9):1336-41. doi: 10.5980/jpnjurol1989.85.1336.
In order to gain the technical skills for performing laparoscopic pelvic lymphadenectomy, we selected the young pigs (12-15 kg) as the experimental model. Five pigs (male 2, female 3) underwent laparoscopic pelvic lymphadenectomy under intravenous anesthesia. Postoperatively, the pigs were euthanized, and laparatomy was performed to demonstrate the area of dissection. Operation time was from 50 to 80 minutes, and no complication occurred in all cases, mastery came rapidly. Following experimental operation, 21 cases with prostate and/or bladder cancer underwent laparoscopic pelvic lymphadenectomy for staging operation from Nov. 1991 to Oct. 1993. Operation time was from 60 to 310 minutes (mean 137). In one of 21 cases, lymph node metastasis was proved. Eighteen of 21 cases underwent radical prostatectomy or cystectomy between 6 to 24 days after laparoscopic pelvic lymphadenectomy. On radical operation, the adhesion of the post-lymphadenectomy was severe in the patients 8 days after laparoscopic pelvic lymphadenectomy, compared with those within 7 days. Radical operation was seemed to be recommended within 7 days after laparoscopic pelvic lymphadenectomy.
为了掌握腹腔镜盆腔淋巴结清扫术的技术技能，我们选择了12 - 15千克的幼猪作为实验模型。5头猪（2头雄性，3头雌性）在静脉麻醉下接受了腹腔镜盆腔淋巴结清扫术。术后，对猪实施安乐死，并进行剖腹手术以展示解剖区域。手术时间为50至80分钟，所有病例均未发生并发症，很快就掌握了该技术。在实验性手术后，1991年11月至1993年10月期间，21例前列腺和/或膀胱癌患者接受了腹腔镜盆腔淋巴结清扫术以进行分期手术。手术时间为60至310分钟（平均137分钟）。21例中有1例被证实有淋巴结转移。21例中的18例在腹腔镜盆腔淋巴结清扫术后6至24天接受了根治性前列腺切除术或膀胱切除术。在根治性手术中，与术后7天内的患者相比，腹腔镜盆腔淋巴结清扫术后8天的患者淋巴结切除术后粘连严重。根治性手术似乎建议在腹腔镜盆腔淋巴结清扫术后7天内进行。
