腹腔镜广泛子宫切除及盆腔淋巴结清扫术治疗宫颈癌并发症分析.docVIP

腹腔镜广泛子宫切除及盆腔淋巴结清扫术治疗宫颈癌并发症分析 　　[摘要] 目的 探讨腹腔镜广泛子宫切除（LRH）及盆腔淋巴结清扫术（LPL）治疗宫颈癌的近期临床疗效。 方法 回顾性分析整群选取2010年4月―2014年6月间该院收治的96例Ia2～IIIa 宫颈癌LRH及LPL术中及术后观察。结果 93例患者成功在腹腔镜下完成手术，3例中转开腹。手术时间228～330 min，平均278 min。术中出血量50～500 mL，平均183 mL；切除盆腔淋巴数11～67枚，平均29.7枚。术后胃肠功能恢复时间1.5～3 d，平均2.6 d。该研究中患者恢复自主排尿的中位时间为26.3 d，术中并发症1例血管损伤；术后主要并发症10例，1例输尿管狭窄，4例下肢静脉血栓形成，4例淋巴囊肿，1例盆腔脓肿；晚期并发症有26例膀胱功能障碍。结论 腹腔镜下广泛子宫切除及盆腔淋巴结清扫术治疗宫颈癌，术式安全有效，并发症发生率和中转开腹率低，可以作为宫颈癌治疗的常规术式。 　　[关键词] 宫颈癌；腹腔镜；广泛子宫切除术；淋巴清扫术；并发症 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2015）12（c）-0083-03 　　Analysis of Laparoscopic Radical Hysterectomy and Pelvic Lymphadenectomy in Treatment of Complications of Cervical Cancer 　　CHEN Ri-xiao， ZHANG Xiao-wei 　　Obstetrics and Gynecology Department， The First Affiliated Hospital of Guangzhou Medical University， Guangzhou， Guangdong Province， 510120 China 　　[Abstract] Objective To study the short-term clinical curative effect of laparoscopic radical hysterectomy and pelvic lymphadenectomy in treatment of cervical cancer. Methods 96 cases of patients with cervical cancer from Ia2 stage to IIIa stage admitted and treated in our hospital from April 2010 to June 2014 were selected and their data were retrospectively analyzed， the patients were treated with LRH and LPL， and the intraoperative and postoperative conditions were observed. Results 93 cases of patients had successfully finished operation under laparoscope， 3 cases were converted to laparotomy， the operation time was 228-330min， 278min averagely， the intraoperative blood loss was 50-500ml， 183ml averagely， the excision number of pelvic lymph was 11-67， 29.7 averagely， the recovery time of postoperative gastrointestinal function was 1.5-3d ， 2.6d averagely， in this study， the medium time of the recovery of automatic micturition of patients was 26.3d， 1 case was complicated by vascular injury in operation， and complications occurred to 10 cases after operation， ureterostenosis occurred to 1 case， deep venous thrombosis occurred to 4 cases， lym