腹腔镜改良腹膜后淋巴结清扫术治疗临床Ⅰ期睾丸非精原细胞瘤的疗效评价:附7例报告

Efficacy of modified laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell tumor:Report of 7 cases

目的探讨经腹途径腹腔镜改良腹膜后淋巴结清扫术治疗临床Ⅰ期睾丸非精原细胞瘤的疗效。方法回顾性分析2008年7月至2010年6月在中山大学肿瘤防治中心收治的7例临床Ⅰ期睾丸非精原细胞瘤的患者,均于睾丸癌根治术后接受腹腔镜改良腹膜后淋巴结清扫术。结果 7例患者腹腔镜改良腹膜后淋巴结清扫术的平均手术时间302.9±88.3min(190～410min),术中平均出血量为111.4±83.2m(l30～200ml),送病理检查的淋巴结平均22.8±11.1枚(9～36枚),无手术并发症发生。术后平均住院时间6d。术后病理分期均为Ⅰ期。所有患者随访2～24个月,平均14.1±8.2个月,均无肿瘤复发或转移,血AFP和β-HCG亦无异常升高,所有患者都维持正常射精功能。结论腹腔镜改良腹膜后淋巴结清扫术能够有效地治疗临床Ⅰ期睾丸非精原细胞瘤,同时具有并发症少和切口美观、创伤小的优势。

Ojective To evaluate the efficacy of modified laparoscopic retroperitoneal lymph node dissection（L-RPLND） for clinical stage I non-seminomatous germ cell tumors（NSGCTs）.Methods Clinical data of 7 cases with clinical stage I NSGCTs from July 2008 to June 2010 in Sun Yat-sen University Cancer Center were retrospectively analyzed.All cases received modified L-RPLND after radical orchidectomy.Results The mean operating time of modified L-RPLND was 302.9±88.3 min（190-410） and the mean blood loss was 111.4±83.2 ml（30-200）.The mean number of dissected lymph nodes sent for pathological examination was 22.8±11.1（9-36）.There were no intra-operation and post-operation complications.The mean hospital stay time after operating was 6 days.Pathological stage（PS） I disease was found in all 7cases.The mean follow-up time was 14.1±8.2 months（2-24）.All patients achieved tumor-free survival,without elevation of blood alpha-fetal protein（AFP） or human chorionic gonadotropin（HCG）.All the patients achieved antegrade ejaculation.Conclusion Modified L-RPLND achieves satisfactory outcomes in clinical stage I NSGCTs with few complication.