皮肤多点靶位固定技术在阴茎癌腹股沟淋巴结清扫中的应用

Application of skin multi-point target fixation technique in the dissection of inguinal lymph nodes in penile cancer

目的:探讨通过皮肤多点靶位固定技术联合腹腔镜下腹股沟淋巴结清扫术(LILND)在阴茎癌患者中的应用。方法:回顾性分析安康中心医院泌尿外科2011年9月至2023年10月收治的阴茎癌患者26例,根据术后是否采用靶位固定技术分为研究组16例和对照组10例。研究组术中采取皮肤多点靶位固定技术LILND,对照组采取常规LILND。其中研究组10例经下腹部皮下(LILND-H),6例经下肢股部皮下(LILND-L),对照组6例LILND-H,4例LILND-L。比较组间基线资料、术中出血量、手术时间、淋巴结清扫数目、住院时间、引流管留置时间及并发症。结果:两组切口感染率差异有统计学意义(P<0.05)。研究组LILND-H患者中2例术后发生下肢水肿,1例术后伤口感染,1例淋巴囊肿。研究组LILNDH住院时间和负压引流置管时间分别为(10.30±2.00)d、(6.56±0.97)d,LILND-L住院时间和负压引流置管时间分别为(10.00±1.79)d、(6.42±0.93)d,对照组LILND-H住院时间和负压引流置管时间为(12.67±1.51)d、(8.44±1.42)d,LILND-L住院时间和负压引流置管时间分别为(7.79±0.65)d、(12.75±1.71)d,差异均有统计学意义(P<0.05)。结论:LILND联合皮肤多点靶位固定技术治疗阴茎癌疗效确切,不仅达到良好的瘤控效果,同时恢复快、创伤小、并发症发生率低。

Objective:To explore the application of skin multi-point target fixation technique combined with lap aroscopic inguinal lymph node dissection(LILND)in patients with penile cancer.Methods:26 patients with penile cancer admitted to the Department of Urology,Ankang Central Hospital from September 2011 to October 2023 were retrospectively analyzed.They were divided into a study group(16 cases)and a control group(10 cases)based on whether the target fixation technique was used after surgery.The study group underwent LILND using the multipoint skin target fixation technique,while the control group underwent conventional LILND.In the study group,10 cases underwent through the lower abdomen subcutaneous dissection(LILND-H),6 cases through the lower limbs(LILND-L),and in the control group,there were 6 cases of LILND-H and 4 cases of LILND-L.Baseline data,intraoperative blood loss,operative time,number of lymph nodes dissected,length of hospital stay,catheter retention time,and complications were compared between groups.Results:There was a significant difference in incision infection rate between the two groups(P<0.05).In the study group who underwent LILND-H,postoperative lower limb edema occurred in 2 patients;one patient had postoperative wound infection;and one patient developed lymphocyst.The hospital stay and negative pressure drainage tube placement time of LILND-H patients in the study group were(10.30±2.00)d and(6.56±0.97)d respectively;those of LILND-L patients were(10.00±1.79)d and(6.42±0.93)d respectively.In contrast,the hospital stay and negative pressure drainage tube placement time of LILND-H patients in the control group were(12.67±1.51)d and(8.44±1.42)d respectively,and those of LILND-L patients were(7.79±0.65)d sand(12.75±1.71)d respectively with statistical significance(P<0.05).Conclusion:The combination of laparoscopic inguinal lymph node dissection(LILND)with skin multi-point target fixation technique for treating penile cancer is effective,achieving excellent tumor control while promoting rapid recovery,minimal trauma,and a low incidence of complications.