南方医科大学学报2012，Vol.32Issue(2)：226-229,4.DOI:44-1627/R.20120209.1459.024
单孔腹腔镜后腹膜淋巴结清扫术3例临床分析:附1年随访报告
Laparoendoscopic single-site retroperitoneal lymph node dissection: initial experience and 1-year follow-up
摘要
Abstract
Objective To summarize our initial experience with laparoendoscopic single-site (LESS) retroperitoneal lymph node dissection (RPLND) for treatment of nonseminomatous testicular cancer. Methods From September 2010 to June 2011, 3 patients (aged 19-27 years) with right testicle enlargement and elevated alpha-fetoprotein level underwent right radical orchidectomy. Histopathological analysis revealed nonseminomatous germ cell tumor. LESS-RPLND was performed 3 weeks after orchiectomy. The homemade port was inserted through a 3-cm right pararectal incision in the right lower quadrant for unilateral RPLND using nerve-sparing technique and modified right-sided template removal similar to those in open RPLND. Results The operation was successfully performed with a mean operative time of 240 min and a mean estimated blood loss of 50 ml. No conversion to open or conventional laparoscopic surgery was required. No major perioperative complications were observed. For the first case, the number of lymph nodes obtained for final histopathological examination was 11, and two positive nodes were detected. For the other 2 cases, no positive nodes were detected. Chemotherapy was administered in the first case. Alpha-fetoprotein level decreased close to the baseline one week postoperatively and no relapse occurred in these cases 3 month after RPLND. Follow-up at 1 year after the surgery showed good tumor control and preservation of the sexual function. Conclusions LESS-RPLND is safe and feasible for treatment of nonseminomatous testicular cancer, and the pararectal incision provides an ideal surgical approach with good cosmetic result, but the long-term effect needs to be tested by further large population-based study.关键词
单孔腹腔镜/后腹膜淋巴结清扫术/非精原细胞瘤/睾丸肿瘤Key words
laparoendoscopic single-site surgery/ retroperitoneal lymph node dissection/ nonseminomatous germ cell tumors/ testicular cancer分类
医药卫生引用本文复制引用
徐啊白,李虎林,郑少波,赵国平,申海燕,刘春晓..单孔腹腔镜后腹膜淋巴结清扫术3例临床分析:附1年随访报告[J].南方医科大学学报,2012,32(2):226-229,4.基金项目
广东省卫生厅适宜卫生技术推广项目(粤卫[2010]152号) （粤卫[2010]152号）
