Bouchot O, Boullanger P, Buzelin J M
Clinique Urologique, CHU Nantes, France.
Prog Urol. 1997 Sep;7(4):665-73.
Lymph node invasion is one of the major prognostic factors of cancer of the penis. However, as it is difficult to evaluate clinically and by means of complementary investigations, inguinal or even ilioinguinal lymph node dissection is still indicated. As this surgery carries a certain morbidity (necrosis of skin edges, infection, lymphorrhoea and subsequent lymphoedema), the indications are presented according to the presence or absence of palpable inguinal lymph nodes and the stage of the primary tumour. Various surgical techniques are proposed: Superficial and deep inguinal lymph node dissection in the case of mobile and palpable inguinal nodes, simplified and superficial inguinal lymph node dissection in the absence of palpable inguinal nodes and in the case of invasive primary tumour.
淋巴结侵犯是阴茎癌的主要预后因素之一。然而，由于临床上难以评估且通过辅助检查手段也难以判断，因此腹股沟甚至髂腹股沟淋巴结清扫术仍有必要进行。由于该手术存在一定的发病率（皮肤边缘坏死、感染、淋巴漏及随后的淋巴水肿），手术指征根据腹股沟淋巴结是否可触及以及原发肿瘤的分期来确定。目前提出了多种手术技术：对于可活动且可触及的腹股沟淋巴结，行浅表及深部腹股沟淋巴结清扫术；对于未触及腹股沟淋巴结且原发肿瘤为浸润性的情况，行简化浅表腹股沟淋巴结清扫术。
