Laparoscopic bilateral retroperitoneal and pelvic lymph node dissection via abdominal approach in supine position: 3 cases report and literature review
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摘要:
目的探讨睾丸癌平卧位腹腔镜下经腹途径双侧腹膜后及盆腔淋巴结清扫术的方法。 方法采用经腹途径性腹腔镜下双侧腹膜后及盆腔淋巴结清扫术3例，复习总结国内外相关文献。 结果3例手术均顺利，术中分别清扫双侧腹膜后淋巴结22个，及盆腔淋巴10个，术中出血少，术后安返病房。 结论腹腔镜下经腹途径双侧腹膜后及盆腔淋巴结清扫范围广，上至肾动脉水平，下至髂总下约2 cm，解剖标志清晰，可达到与开放手术相同的切除范围，仰卧位能同时清扫双侧腹膜后淋巴结及盆腔淋巴，避免中途左右转换体位的麻烦，降低手术风险，可应用于非精原细胞瘤的淋巴结诊断及治疗。 Abstract:ObjectiveTo explore the method of laparoscopic bilateral retroperitoneal and pelvic lymph node dissection for testicular cancer in supine position. MethodsBilateral retroperitoneal and pelvic lymph node dissection via laparoscopy were performed in 3 cases. The literatures at home and abroad were reviewed and summarized. ResultsDuring the operation, 22 retroperitoneal lymph nodes and 10 pelvic lymph nodes were dissected, with less bleeding during the operation and returned to the ward safely after the operation. ConclusionLaparoscopic bilateral retroperitoneal and pelvic lymph node dissection through abdominal approach has a wide range, ranging from the level of the upper renal artery to the level of the lower iliac artery, with clear anatomical markers. It can achieve the same resection range as open surgery. Supine position can simultaneously remove bilateral retroperitoneal lymph nodes and pelvic lymph nodes, avoid the trouble of changing positions from left to right, and reduce the risk of operation. It can be applied to non-spermatogonial cells. Diagnosis and treatment of lymph nodes. -
[1] Shaw J. Diagnosis and treatment of testicular cancer[J]. Am Fam Physic, 2008, 77(5): 469-74. [2] Kollmannsberger C, Daneshmand S, So A, et al. Management of disseminated nonseminomatous germ cell tumors with riskbased chemotherapy followed byresponse-guided postchemotherapy surgery[J]. J Clin Oncol, 2010, 62(28): 537-42. [3] Ehrlich Y, Brames MJ, Beck SD, et al. Long-term follow-up of cisplatin combination chemotherapy in patients with disseminated nonseminomatous germcell tumors:is a postchemotherapy retroperitoneal lymph node dissection needed aftercomplete remission[J]. Clin Oncol, 2010, 28(6): 531-6. [4] Steyerberg EW, Keizer HJ, Habbema JD. Prediction models for the histology of residual masses after chemotherapy for metastatic testicular cancer[J]. Intern J Cancer, 1999, 83(6): 856-9. doi: 10.1002/(SICI)1097-0215(19991210)83:6<856::AID-IJC31>3.0.CO;2-L [5] Carver BS, Shayegan B, Serio A, et al. Long-term clinical outcome after postchemotherapy retroperitoneal lymph node dissection in men with residual teratoma[J]. J Clin Oncol, 2007, 25(9): 1033-7. doi: 10.1200/JCO.2005.05.4791 [6] Oldenburg J, Alfsen GC, Lien HH, et al. Postchemotherapy retroperitoneal surgery remains necessary inpatients with nonseminomatous testicularcancer and minimal residual tumor masses[J]. J Clin Oncol, 2003, 57(21): 3310-7. [7] Whitmore WF. Surgical treatment of adult germinal testis tumors[J]. Semin Oncol, 1979, 6(1): 55-68. [8] Steiner H, Peschel R, Janetschek G, et al. Long term results of laparoscopic retroperitoneal lymph node dissection:a single-center 10-year experience[J]. J Urol, 2004, 63(3): 550-5. doi: 10.1016/j.urology.2003.09.067 [9] 那彦群, 孙光. 中国泌尿外科疾病诊断治疗指南[M]. 北京: 人民卫生出版社, 2013: 80-104. [10] 马 鑫, 张 旭, 李宏召, 等. 腹腔镜腹膜后淋巴结清扫术9例报告[J]. 中国微创外科杂志, 2005, 5(6): 421-3. doi: 10.3969/j.issn.1009-6604.2005.06.001 [11] Mero FF, Wagner A, Brito FA. Refining the lapa-roseopic retrope"toneaI lymphnode dissection for teaticular cance[J]. Int Braz J Urol, 2006, 32(2): 196-201. doi: 10.1590/S1677-55382006000200012 [12] Baniel, J, Foster RS, Gonin R, et al. Late relapseof testicular cancer[J]. J Clin Oncol, 2012, 29(13): 1170-6. [13] Janetschek G, Hobisch A, Peschel R, et al. Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous testicular carcinoma: long-term outcome[J]. J Urol, 2000, 163(6): 1793-6. doi: 10.1016/S0022-5347(05)67545-3 [14] Kenney PA, Tuerk IA. Complications of laparoscopic retroperitoneal lymph node dissection in testicular cancer[J]. World J Urol, 2008, 26(6): 561-9. doi: 10.1007/s00345-008-0299-3 [15] Vidal-Morai V, Castillo OA. Retmperitoneal laparoscopic lymph node dissection (RPLND) in testieular cancer[J]. Arch Esp Urol, 2010, 63(4): 373-9. [16] 叶定伟, 方银忠, 戴 波, 等. 睾丸肿瘤腹膜后淋巴结清扫术39例报告[J]. 中华泌尿外科杂志, 2005, 26(4): 283-5. doi: 10.3760/j:issn:1000-6702.2005.04.019 [17] Schwartzmj, Kavoussi LR, Controversial T. The chunne landthe lapaaros copicretroper itonea llymph node dissection[J]. BJU Int, 2010, 106(6): 950-9. [18] Neyer M, Peschel R, Akkad T, et al. Long-term results of laparoscopic retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testicular cancer[J]. J Endourol, 2007, 21(2): 180-3. doi: 10.1089/end.2006.0233 [19] CorvinS, Kuczyk M, Anastasiadis A, et al. Laparoscopie retroperitone-allymphnode dissection for nonseminomatous testicular carcinoma[J]. World J Urol, 2004, 22(1): 33-6. doi: 10.1007/s00345-004-0400-5 -
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