Comparative Efficacy Of Laparoscopic Inguinal Lymph Node Dissection And Open Inguinal Lymph Node Dissection

OBJECTIVE:The article evaluates operative effect and clinical significance of laparoscopic inguinal lymph nodes dissection by comparison with open inguinal lymph nodes dissection, thus provides scientific basis to generalise the surgery methods.METHODS:The article retrospectively analyzes58cases of penile cancer patients undergoing inguinal lymph nodes dissection from January2010to December2013in urology department of xiangya hospital central south university. These patients all undergo bilateral inguinal lymph nodes dissection(30laparoscopic inguinal lymph nodes dissections and28open inguinal lymph nodes dissections). Compare the two groups in clinical data, perioperative informations and postoperative follow-up data.RESULTS:No laparoscopic surgery is converted to open surgery. Total time of lymph nodes dissection lasts for120-245min, average (159.3±30.1) min. Blood loss amounts to30～70ml, average (45.5±6.7) ml. The number of lymph nodes dissected amounts to4to12, average (8.6±2.0) each side, totally531and10pieces are positive. The use of acesodyne postoperatively lasts for0～2d, average (0.83±0.70d). The hospital stay lasts for4～7d, average (4.8±0.96) d. Total hospitalization expense amounts to12620.40～15358.80yuan, average (13627.6±803.11yuan). All patients leave hospital with a drainage tube, and indwelling of drainage tube lasts for5～10d, average (7.6±1.5) d.30patients with a total of60sides postoperative complications:2sides lateral incision cellulitis,3sides seroma healed,4sides lymphocele,5sides lower extremity edema.28cases of open surgery group:total time cleaning operation90125min, an average of105.9±10.6min, blood loss60-130ml, an average of90.6±17.9ml, the number of lymph node dissection is5to14, with an average8.5±2.0eggs/side, a total of472lymph nodes, where positive lymph nodes is8. Postoperative pain relievers application time1～5d, with an average of1.93±0.56d; hospitalization time7-18d, average9.5±1.5d; hospitalization expenses13,045.3-21,350.3yuan, with an average14120.3±2015.8million. Were discharged from hospital after surgery with a pipe drainage tube indwelling time8-18d, average11.4±2.2d. Postoperative complications:wound infection3sides, a total of eight sides skin necrosis, lymphatic leakage in4sides,5side lymphocyst, six side and severe lower extremity edema, no case of a large area of skin flap necrosis, deep vein thrombosis, lower limb movement disorder, scrotal edema. Preoperative data comparison, no significant difference.In clinical outcome measures:The number of lymph node dissection, and the ratio of positive lymph nodes was no statistical difference between the two groups; in operative time, blood loss, postoperative pain medication application time, length of stay, hospital costs, drainage tube removed a few days, postoperative complications etc., a statistically significant difference between the two groups, in addition to laparoscopic surgery time leader in open group, and the rest are better than open surgery group.CONCLUSIONS:The study has confirmed that compared with open surgery, laparoscopic inguinal lymph node dissection is not only able to achieve the same effect of controlling tumor, but also significantly reduces postoperative complications, shortens hospital stay, alleviates the sufferings of patients and reduces the expense. It is a safe, viable treatment against penile cancer with lymph node metastasis, and deserves to be generalized.