摘要
目的总结阴茎恶性肿瘤的手术治疗经验,并随访分析其手术相关并发症和预后情况。方法回顾性收集2015年1月至2020年12月我院收治的50例阴茎癌患者的年龄、发病病程、影像学检查结果、手术方式、病理检查结果、预后、术后复查时间及结果、并发症及处理方法、随访时生存状态等资料,并进行分析。结果50例患者中46例行阴茎部分切除术,4例行阴茎全切术联合会阴部造口术;19例患者同时行淋巴结清扫术,其中6例患者行双侧改良腹股沟淋巴结清扫术,7例行双侧腹股沟淋巴结标准清扫术,6例行双侧髂腹股沟淋巴结清扫术。术后病理示鳞状细胞癌43例(高分化19例、中分化23例、低分化1例),疣状癌4例,湿疣样癌2例,鳞状上皮乳头状瘤1例。患者定期随访3~70个月,中位随访时间为36.50(25.25,52.50)个月,有10例患者出现术后并发症,包括尿道外口狭窄3例、阴茎切口感染1例、腹股沟区切口皮瓣坏死伴感染2例、淋巴水肿4例。随访期间有5例患者死亡,其余存活良好。结论对于阴茎癌患者来说,合理地选择肿瘤切除方式,根据指征合理地选择腹股沟淋巴结清扫的时机和方式,可显著提高患者生存率并减少并发症。
Objective To summarize the surgical treatment experience of malignant penile tumors and analyze the postoperative complications and prognosis.Methods A total of 50 penile cancer patients treated in our hospital from Jan.2015 to Dec.2020 were retrospectively selected.The following indicators were analyzed:age,disease course,radiological examinations,surgical approaches,pathological findings,prognosis,postoperative follow-up time and outcomes,complications and their management,as well as survival status during the follow-up.Results Among the 50 patients,46 patients underwent partial penectomy for penile cancer.Total penectomy with perineal urethrostomy were performed in 4 cases.Nineteen patients underwent lymph node dissection at the same time:6 patients underwent bilateral modified inguinal lymphadenectomy,7 patients underwent bilateral standard inguinal lymphadenectomy,and 6 patients underwent bilateral ilioinguinal lymphadenectomy.Postoperative pathology showed 43 cases of squamous cell carcinoma(including 19 cases with high differentiation,23 cases with medium differentiation,and 1 case with low differentiation),4 cases of verrucous carcinoma,2 cases of warty carcinoma,and 1 case of squamous epithelial papilloma.The patients were regularly followed up for 3-70 months,with a median of 36.50(25.25,52.50)months.Ten patients experienced postoperative complications(incuding 3 cases of urethral stenosis,1 cases of penile incision infection,2 cases of groin incision necrosis with infection,and 4 cases of lymphedema).During the follow-up period,5 patients died,while the rest survived well.Conclusion For patients with penile cancer,reasonable choice of surgical procedures for the resection of tumor and reasonable choice of inguinal lymph node dissection time and method according to the indications can significantly improve the survival rate and reduce complications.
作者
任冠宇
王磊
朴曙光
许成
刘智勇
REN Guanyu;WANG Lei;PIAO Shuguang;XU Cheng;LIU Zhiyong(Department of Urology,The First Affiliated Hospital of Naval Medical University(Second Military Medical University),Shanghai 200433,China)
出处
《海军军医大学学报》
CAS
CSCD
北大核心
2023年第8期952-957,共6页
Academic Journal of Naval Medical University
