【摘要】 目的探讨腹腔镜腹膜后淋巴结清扫术的手术技术和临床可行性。方法9例原发性睾丸非精原细胞性生殖细胞肿瘤根治性睾丸切除术后平均(4.6±1.3)周行腹腔镜腹膜后淋巴结清扫术(laparoscopicretroperitoneallymphnodedissection,L-RLND),记录手术时间、出血量、术后肠功能恢复时间、引流管拔除时间、住院时间和术中、术后并发症,并进行术后随访。结果9例L-RLND均获成功。手术时间(148±9)min,术中出血量(66±8)ml,术后肠功能恢复时间24～48h,住院时间(7.5±1.8)d。术中发生下腔静脉损伤1例,腹腔镜下缝合;2例术后轻微的乳糜性腹膜后引流液,限制脂肪性饮食,术后1周内乳糜漏消失。9例随访6～36个月,平均21.3月,无复发及远处转移。结论腹腔镜腹膜后淋巴结清扫紧靠大血管操作,手术难度及风险较大,须熟练掌握各种腹腔镜操作技术才能减少手术并发症的发生。更多还原

【Abstract】 Objective To investigate surgical techniques and the clinical feasibility of laparoscopic retroperitoneal lymph node dissection (L-RLND). Methods Nine patients with primary testicular nonseminomatous germ cell tumors (NSGCT) received L-RLND) at 4.6±1.3 weeks after orchiectomy. The operating time, intraoperative blood loss, postoperative intestinal function recovery time, drainage removal time, hospital stay, intra- and post-operative complications were recorded. Results The L-RLND) was successfully performed in all the 9 patients. The operating time was 148±9 min, the intraoperative blood loss was 66±8 ml, the postoperative intestinal function recovery time was 24~48 hours, and the hospital stay was 7.5±1.8 days. The inferior vena cava was injuried during operation and was sutured laparoscopically in 1 patient. Mild chylous retroperitoneal drainage was seen in 2 patients, which was cured within 1 week after operation by restriction of high-fat diet. Follow-up for 6~36 months in the 9 patients revealed no evidence of recurrence or distant metastasis. Conclusions A difficult and complicated procedure performed near the large vessels, L-RLND needs more experiences on laparoscopic techniques to minimize complications.更多还原