外阴癌腹腔镜下腹股沟淋巴清扫术手术体位的改进探讨.docVIP

外阴癌腹腔镜下腹股沟淋巴清扫术手术体位的改进探讨 　　摘要：目的探讨外阴癌腹腔镜下腹股沟淋巴结清扫术时的最佳手术体位。方法对外阴癌腹腔镜下双侧腹股沟淋巴结清扫术中3种不同手术体位，对手术时间、医生对手术操作空间满意度、患者术后舒适度、术后切口感染率等方面进行比较。结果2例安置传统手术体位患者手术平均用时162.5 min（159~166 min），此体位虽然医生对手术操作空间满意，但患者术后舒适度较低、手术时间长、术中更换体位时耗费过多人力和物资。2例全麻前安置改良截石位患者手术平均用时135.6 min（131~140.2 min），此体位虽然手术时间有所缩短、术中不再更换体位、患者术后舒适度较高，但医生对手术操作空间满意度低。12 例采用本文改进的截石位患者手术平均用时113.6 min（80~134 min），此体位不仅医生对手术操作空间满意、患者术后舒适度高，而且缩短了手术时间、术中只调整体位不再更换体位。结论本文推荐的改进截石位，是外阴癌腹腔镜下腹股沟淋巴结清扫术中值得推广应用的体位。 　　关键词：外阴癌；腹腔镜；腹股沟淋巴结；体位；截石位 　　Research on the Improvement of the Superior Position of the Patient in the Laparoscopic Inguinal Lymphadenectomy of Vulval Carcinoma 　　CUIWei1,BAI Ting-lian2，WANGYan2 　　(1.Operation Room,SichuanMiyi County Peoples Hospital, Miyi 617200,Sichuan,China;2.Operation Room,Sichuan Academy of Medical Science ? Sichuan ProvincialPeoplesHospital，Chengdu 610072，Sichuan,China) 　　Abstract：ObjectiveTo explore a superior position of the patient in the laparoscopic inguinal lymphadenectomyof vulval carcinoma.MethodsTo compare three different positions of these patients from various aspects, including the length of the operation time, the surgeons feelings, the patients feelings, and the infection rates after the operation, ResultsTwo patients with the traditional position need 162.5 mins to finish the operation,. Although the surgeons feel good during the entire peocedure, more nursers and time should be provided. Two patients with the reorganized position before anesthesia need 135.6 mins totally. But it doesnt provide more conveniences for the doctors. 12 patients adopt our bladder lithotomy position.The mean operation time is 113.6mins, which is shorter than the other two groups.The surgeonsand the patients feel good and there is no need to change the position during the operation.ConclusionThe bladder lithotomy position referred in our paper is worthy of recommendation. in laparoscopic inguinal lymphadenectomy. 　　Key words：Vulval Carcinoma; Laparoscope; Inguinal Lymph Nodes; Position; Lithotomy