双通道扩张下腹皮下隧道顺行阴茎癌腹股沟淋巴结清扫术6例报道

Double-channel expansion of the subcutaneous lower abdominal tunnel for sequential inguinal lymph node dissection in penile cancer—Report of six cases

目的:探讨双通道扩张行下腹皮下隧道顺行阴茎癌腹股沟淋巴结清扫术的安全性及有效性。方法:回顾性分析2020年1月至2022年12月收治的6例采用双通道扩张下腹皮下隧道顺行阴茎癌淋巴结清扫术的患者临床资料。结果:6例(12侧)均顺利完成预防性腹股沟淋巴结清扫术,腔镜清扫时间(82.50±12.08)min/侧,出血量(28.33±10.95)ml,清扫淋巴结数目[浅组(11.16±1.02)枚,深组(0.67±0.74)枚],术后病理均为阴性。术后住院时间(7.330±1.60)d,拔管时间(12.00±2.06)d,术后并发症:皮肤感觉异常5侧、下肢水肿3侧、淋巴篓3侧、蜂窝织炎1侧,随访时间(20.60±12.51)个月,所有患者腹股沟区无肿瘤复发和转移。结论:双通道扩张下腹皮下隧道顺行腹股沟淋巴结清扫术治疗阴茎癌安全可行,并发症率低,能彻底清扫腹股沟淋巴结且手术时间有优势。

Objective:To investigate the safety and efficacy of the two-channel dilatation procedure for subcutaneous tunneling in the lower abdomen during pelvic lymph node dissection for penile cancer.Methods:A retrospective analysis was conducted on the clinical data of 6 patients treated from January 2020 to December 2022 using the dual-channel expansion technique for penile cancer lymph node dissection.Results:All 6 cases(12 sides)successfully underwent prophylactic inguinal lymph node dissection.The average laparoscopic dissection time was(82.50±12.08)minutes per side,with an average blood loss of(28.33±10.95)ml.The number of lymph nodes dissected was(11.16±1.02)for the superficial group and(0.67±0.74)for the deep group.Postoperative pathology was negative in all cases.The average postoperative hospital stay was(7.33±1.60)days,with a catheter removal time of(12.00±2.06)days.Postoperative complications included abnormal skin sensations in 5 sides,lower limb edema in 3 sides,lymphedema in 3 sides,and cellulitis in 1 side.During a follow-up period of(20.60±12.51)months,there were no instances of tumor recurrence or metastasis in the inguinal region among the patients.Conclusion:The dual-channel expansion technique for inguinal lymph node dissection via a subcutaneous tunnel is a safe and feasible treatment for penile cancer.It has a low complication rate,allows for thorough dissection of inguinal lymph nodes,and offers advantages in terms of surgical time.