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目的比较腹腔镜与开放阴茎癌腹股沟淋巴结清扫术临床疗效。方法回顾性分析我院自2013年4月至2016年3月行腹腔镜手术(laparoscopic surgery,LS)和开放手术(open surgery,OS)共28例患者的资料,其中LS组13例,OS组15例。对两组患者的术前基本资料、围术期数据、术后并发症情况进行对比分析。结果 LS组较OS组具有术中出血量少,术后引流管留置时间短,术后住院时间短,术后皮瓣坏死率低的特点。LS组较OS组手术时间长,差异(P=0.001),两组患者在淋巴结清扫个数(P=0.348)、淋巴结阳性率(P=0.788)以及术后切口感染(P=0.640)、淋巴囊肿(P=0.524)、淋巴漏(P=0.918)、血清肿(P=0.348)及下肢水肿(P=0.763)方面差异均无统计学意义。13例患者随访6~41个月,平均22个月,未出现复发和转移。结论腹腔镜下腹股沟淋巴结清扫术同开放手术相比,安全可行,治疗效果肯定,具有术中出血量少,住院时间短,术后皮瓣坏死率低等优点。
Objective To compare the clinical efficacy of laparoscopic and open penile lymph node dissection. Methods The data of 28 patients with laparoscopic surgery (LS) and open surgery (OS) from April 2013 to March 2016 in our hospital were retrospectively analyzed. Among them, 13 patients in LS group, OS group 15 cases. Preoperative baseline data, perioperative data and postoperative complications were compared between the two groups. Results Compared with OS group, LS group had less intraoperative blood loss, shorter postoperative drainage tube indwelling time, shorter postoperative hospital stay and postoperative flap necrosis rate. The number of lymph node dissection (P = 0.348), lymph node positive rate (P = 0.788) and postoperative incision infection (P = 0.640) in lymph nodes in LS group were longer than those in OS group (P = 0.001) Cyst (P = 0.524), lymphatic drainage (P = 0.918), seroma (P = 0.348) and lower extremity edema (P = 0.763) showed no statistical significance. Thirteen patients were followed up for 6 to 41 months with an average of 22 months without recurrence and metastasis. Conclusions Laparoscopic inguinal lymph node dissection is safe and feasible compared with open surgery, and the treatment effect is definite. It has the advantages of less intraoperative blood loss, shorter hospital stay, and lower necrosis rate of postoperative flap.