A Retrospective Study On Comparison Of Laparoscopic And Open Surgery For Laparoscopic Inguinal Lymph Node Dissection

Objective To compare the clinical efficacy of laparoscopic surgery and open surgery for inguinal lymph node dissection.(2)To evaluate the effects between video endoscopic inguinal lymphadenectomy and open inguinal lymphadenectomy to provide the evidence-based basis for the selection of the clinical therapy schemes.Methods twenty-nine patients with LS and OS for the treatment of laparoscopic bilateral inguinal lymph node dissection from April 2013 to October 2017 were retrospectively reviewed.A total of 14 patients received LS and and 15 cases of OS were enrolled for comparison.The demographic parameters of patients,perioperative data,postoperative complication and oncology results were recorded and evalu ated.The criteria for inclusion and exclusion were formulated,with witch the following databases were searched,including PubMed?The Cochrane Library?EBSCO?Elsevier?WanaFang database and China National Knowledge Infrastructure(CNKI).meta-analysis for screening and quality estimated were calculated with Review Manager 5.3.Results The LS group had less extimated blood loss(P = 0.000),shorter drainage tube indwelling time(P = 0.000),shorter hospital stay(P = 0.012),less skin necrosis(P = 0.031),more surgical time(P = 0.001)compared with the OS group.There was no difference in the mean number of dissected lymph nodes(P ?0.352)and lymph node positive rate(P= 0.767)between the two groups.There was no difference in term of wound infection(P = 0.653),lymphocele(P =0.605),lymphatic leakage(P=0.893),Hematoncus(P=0.342),lower limb edema(P=0.757).At a mean follow-up of 34months(range from 5 to 58 mouths,no signs of recurrence and metastasis was noted.6 eligible studies involving 231 participants(109 LS and 122 OS)were included in our meta analysis.The LS group reduced the total blood loss(WMD =-25.97,95%CI[-48.77,-3.18],P=0.03),surgical complications(OR=0.01,95%CI[0.04,0.25],P<0.00001),drainage tube indwelling time(WMD=-4.33,95%CI[-6.50,-2.15],P<0.0001)and hospital stay(WMD=-2.99,95%CI[-3.52,-2.45],P<0.00001).between the two groups,There was no difference in term of surgical time(WMD=2.82,95%CI[-36.50,42.14],P=0.89)?the number of dissected lymph nodes(WMD=-0.67,95%CI[-1.52,0.18],P=0.12)and lymph node positive rate(WMD=-0.04,95%CI[-0.33,0.26],P=0.81).Conclusion Laparoscopic surgery shows some advantages in reduction of skin necrosis,wound healing time,and surgery hemorrhage over open surgery.It is same efficiency as open surgery.LS has equivalent efficacy to OS,but has less surgical complications.