摘要
目的探讨保留阔筋膜腹股沟淋巴结清扫术治疗阴茎癌的肿瘤治疗效果及术后并发症。方法 2002年1月至2011年12月,对104例临床分期≤N2阴茎癌患者施行了201侧次保留阔筋膜腹股沟淋巴结清扫术。采用经典根治术清扫范围,腹股沟浅组淋巴结整块清除。打开股管前方筛筋膜后清扫深组淋巴结,阔筋膜完整保留并与皮下组织点状缝合,未行缝匠肌转位。分析患者的生存、局部复发以及并发症发生情况。结果中位随访时间36个月。平均清扫淋巴结数目为12.5枚/侧。1例(1%)患者术后7个月出现阔筋膜边界以外的局部复发。3年总的疾病特异性生存率为92.1%,其中pN0、pN1、pN2、pN3患者分别为100%、91.3%、80.0%和33.3%。共59次并发症发生(29.3%),包括切口感染(2.5%)、皮瓣坏死(5.5%)、淋巴肿(11.8%)、血清肿(1.5%)、淋巴囊肿(5.0%)、感觉异常(3.5%)和深静脉血栓形成(0.5%)。结论保留阔筋膜腹股沟淋巴结清扫术治疗无淋巴结外侵犯的阴茎癌其控瘤效果与经典根治术相似,但并发症明显减少。
Objective To investigate local groin recurrence and morbidity associated with fas- cia lata preservation during inguinal lymphadenectomy （ILAD） for penile carcinoma. Methods Be- tween January 2002 and December 2011, a total of 20i inguinal dissections with preservation of the fascia lata （ILADPFL） were performed in 104 patients with clinical disease staged at ≤ N2. The boundaries of dissection were the same as that for radical ILAD. All superficial inguinal nodes Were removed en bloc. The cribriform fascia near the^femoral canal was divided, and the deep inguinal lymph nodes were dissected. The fascia lata was completely preserved and sutured to the subcutane- ous tissue. The transposition of the sartorius muscle was eliminated. Survival and morbidity data were retrospectively analyzed, and survival probabilities were calculated. Results The median op- erative time for unilateral ILAD was 45 min （range： 40-60 rain）. Median follow-up was 36 months （range： 10-130 months）. A mean number of 12.5 nodes were removed per groin. One patient （1%） had a recurrence outside the borders of the fascia lata after seven months of follow-up. The three- year disease-free survival rate was 92. 1% （100% for pNo , 91.3%for pN1 , 80.0% for pN2 , and 33.3% for pNa disease）. A total of 59 complications （29.3%） occurred, including wound infection （2.5%）, skin necrosis （5.5%）, lymphedema （11. 8%）, seroma formation （1. 5%）, lymphocele （5.0%）, paresthesia （3.5%）, and deep venous thrombosis （0.5%）. Conclusions ILADPFL for penile carcinoma patients without extranodal extension is as effective as the classic dissection technique,but decreases groin dissection-related complications.
出处
《现代泌尿生殖肿瘤杂志》
2013年第6期329-332,339,共5页
Journal of Contemporary Urologic and Reproductive Oncology
基金
广东省科技计划项目资助(2012B031800079)
