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腹腔镜与开放性腹膜后淋巴结清扫术治疗临床Ⅰ~Ⅱ(a/b)期睾丸非精原细胞瘤的对比 被引量:1

Comparison of laparoscopic retroperitoneal lymph node dissection vs.open surgery for clinical stage Ⅰ-Ⅱ non-seminomatous germ cell tumor
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摘要 目的 探讨腹腔镜与开放性腹膜后淋巴结清扫术治疗临床Ⅰ~Ⅱ(a/b)期睾丸非精原细胞瘤的疗效.方法 遵循随机对照的分配方法,将睾丸非精原细胞瘤患者随机分为两组,腹腔镜腹膜后淋巴结清扫术治疗睾丸非精原细胞瘤11例,开放性腹膜后淋巴结清扫术治疗睾丸非精原细胞瘤11例,通过统计学分析手术时间、术中出血量、淋巴结清扫个数、术后胃肠道功能恢复时间、术后平均住院时间及术后并发症,比较两种术式的手术效果.结果 两组患者手术均获成功,无改变手术方式者.腹腔镜组与开放组的手术时间分别为(165±35) min和(176 ±41) min (P >0.05),术中出血量(101±12) ml和(200±28) ml (P<0.05),淋巴结清扫(16 ±5)个和(17±4)个(P>0.05),术后胃肠功能恢复时间(1.6±0.3)d和(2.2±0.5)d(P<0.05),术后平均住院(7.5±2.8)d和(11.6±3.8)d(P<0.05),腹腔镜组均未出现术后并发症,开放组1例出现伤口延迟愈合,1例出现高热症状.结论 腹腔镜腹膜后淋巴结清扫术相对于开放性手术,具有安全、高效、创伤小及恢复快等特点,此术式对临床Ⅰ~Ⅱ(a/b)期睾丸非精原细胞瘤有很好的疗效. Objective To explore the clinical effects of laparoscopic retroperitoneal lymph node dissection vs.open surgery for clinical stage Ⅰ-Ⅱ nonseminomatous cell tumor.Methods Following the randomized controlled experiment method,the patients were randomly divided into two groups:11 cases of clinical stage Ⅰ-Ⅱ non-seminomatous cell tumor receiving laparoscopic retroperitoneal lymph node dissection,and in the same period,11 receiving open surgery.Through the statistical analysis of the operative time,the intraoperative blood loss,mean dissected lymph node number,the postoperative hospital stay and the postoperative complication,the effect of two surgical procedures was compared.Results All cases were operated successfully without changing surgical approach.Between the laparoscopic and open groups,the mean operation time was (165 ± 35) min vs.(176 ± 41) min (P 〉 0.05),mean blood loss was (101 ±12) ml vs.(200 ±28) ml (P 〈0.05),the mean dissected lymph node number was (16 ±5) vs.(17 ±4) (P 〉 0.05),mean postoperative gastrointestinal function recovery time was (1.6 ± 0.3) days vs.(2.2 ± 0.5) days (P 〈 0.05),and mean postoperative hospital stay was (7.5 ± 2.8) days vs.(11.6 ± 3.8) days (P 〈 0.05).No postoperative complications occurred in the laparoscope group.In the open group,there was one case of wound delayed healing and 1 case of high fever.Conclusion Laparoscopic retroperitoneal lymph node dissection is safe and effective with less trauma and faster recovery,and it can be used as first-line choice for diagnosis and treatment of clinical stage Ⅰ-Ⅱ nonseminomatous cell tumor.
出处 《中华实验外科杂志》 CAS CSCD 北大核心 2015年第5期1193-1195,共3页 Chinese Journal of Experimental Surgery
基金 基金项目:河南省科技厅基础研究项目(142300410405) 河南省教育厅科技技术研究重点项目(14A320097) 河南省科技厅重点攻关计划资助项目(122102000000) 郑州市团队计划资助项目(131PCXTD627)
关键词 非精原细胞瘤 腹腔镜 腹膜后淋巴结清扫 Non-seminomatous cell tumor Laparoscopic Retroperitoneal lymph node dissection
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