改良内镜下腹股沟淋巴结清扫术医护配合

The experiences of nursing cooperation with surgeons in modified endoscopic inguinal lymphadenectomy

目的 总结探讨改良内镜下腹股沟淋巴结清扫术（VEIL）的医护配合经验,为更好配合内镜手术开展及推广提供支持.方法 回顾性总结我院2010年4月至2013年12月9例行双侧改良内镜下腹股沟淋巴结清扫术的阴茎癌患者医护配合特点,统计相关数据.结果 9例患者（18侧）手术在医护配合下均成功完成,单侧手术时间79～121 min,平均时间97 min,手术清扫淋巴结7～11个,平均8个,每例患者术中出血量45～90 ml,平均51ml,无中转开放,无术中并发症;术后除1例患者发生淋巴漏外,无一例发生皮瓣坏死或切口延迟愈合,无出现腘窝血管压迫及压疮.结论改良内镜下腹股沟淋巴结清扫术在保证肿瘤根治效果的同时降低了手术难度,降低了并发症发生率,注意术中医护配合细节,可更好的完成手术,利于该术式规范化及推广.

Objective To summarize the nursing experiences of nine cases of modified endoscopic inguinal lymph node dissection technology （VEIL）. Methods Nine cases of penile cancer enrolled between April 2010 and December 2013 were subjected to bilateral modified endoscopic inguinal lymphadenectomy, and surgical nursing cooperation was also applied. The surgical nurses were familiar with surgical procedures, focusing on the management of instrument, placement of posture and the prevention of intraoperative complications. Results A total of nine cases （18 sides） of modified endoscopic inguinal lymphadenectomy were successfully performed, and no conversion to open surgery and no intraoperative complications. The medium operative time for one side was 97 rain （79-121 min） and an average number of 8 （7-11） lymph nodes were harvested each side. A medium blood loss for one case was 51ml （45-90 ml）. Apart from one patient with postoperative bilateral lymph leakage, the other patients had no lymph leakage, flap necrosis, lymphedema, and wound infection. Conclusions With the cooperation of surgeons and nurses, modified endoscopic inguinal lymphadenectomy is safe and feasible to reduce the postoperative complications.