妇科腹腔镜手术467例临床分析.docVIP

妇科腹腔镜手术467例临床分析 【摘要】目的：探讨妇科腹腔镜的手术方式、手术适应证及其并发症。方法：回顾性分析467例妇科腹腔镜手术患者的临床资料。467例患者均行腹腔镜手术，卵巢囊肿剥除术和附件切除术214例，子宫肌瘤剜除术58例，子宫切除术185例，广泛全子宫切除术+盆腔淋巴清扫术10例，分析不同术式手术相关指标及术后并发症的发生率。结果：腹腔镜手术占同期妇科手术的比例逐渐升高。广泛全子宫+盆腔淋巴结清扫术患者手术时间、出血量、术后住院时间均明显高于其它术式患者（P0.05),不同术式患者术后排气时间差异无统计学意义（P0.05)。腹腔镜手术并发症发生率为0.64%(3/467例) 。结论：腹腔镜手术指征拓宽,手术并发症的发生率降低，合理把握手术适应证,可发挥腹腔镜技术在肿瘤专科医院的优势。 【关键词】 腹腔镜； 妇科肿瘤； 适应证； 并发症 Clinical analysis of laparoscopic procedure in treatment of 467 cases with gynecologic diseases LIU Kaijiang, TANG Jie, LIU Qing, et al （Department of Gynecology, Affiliated Cancer Hospital, Xinjiang Medical University,Urumqi 830011, China） Abstract:　Objective: To appraise the operative technique , indications and complications of gynecologic laparoscopy. Methods: To analyze retrospectively the clinical data of 467 cases with gynecologic diseases who underwent laparoscopic procedure. In 214 patients with benign ovarian cysts underwent laparoscopic operations of cystectomy and adnexectomy, 58 patients underwent myomectomy, 185 patients underwent hysterectomy, and 10 patients underwent radical hysterectomy and lymphadenectomy. Results: More and more patients were undertaken laparoscopy in our hospital. The average operating time , estimated blood loss and the time of hospitalization of cases of radical hysterectomy and lymphadenectomy were significantly more than those of cases of cystectomy and adnexectomy, myomectomy and hysterectomy. Complications occurred in 3 cases (0.64%). Conclusion: With advancement of laparoscopic techniques, the laparoscopic operative indications could be widened with decrease of complications. With proper selection of indication , many gynecologic abdominal surgery may be replaced by laparoscopic procedure in cancer hospital. Key words: laparoscope; gynecologic oncology; indication; complication 近年来,随着腔镜器械的不断进步和手术技巧的不断提高,妇科腹腔镜技术取得前所未有的进展,手术指征已经拓宽到妇科恶性肿瘤的治疗领域,如子宫颈癌［1］、子宫内膜癌［2］,加上并发症发生率逐步降低,因此腹腔镜技术已成为普通妇科及妇科肿瘤常用的手术方法之一。我科2004年5月～2006年3月开展了包括卵巢囊肿剥出术及附件切除术、子宫肌瘤剜出术、全子宫或次全