腹腔镜下宫颈癌根治术32例临床剖析.docVIP

腹腔镜下宫颈癌根治术32例临床剖析 　　【摘要】 目的：探讨腹腔镜下宫颈癌根治术的临床疗效。方法：回顾性分析笔者所在医院32例Ⅰa2～Ⅱa期宫颈癌患者腹腔镜下广泛子宫切除术及盆腔淋巴结和腹主动脉旁淋巴结清扫术的临床资料，观察腹腔镜手术治疗效果。结果：32例患者手术均成功，无一例中转开腹。手术时间（240.06±31.99）min，术中出血量（245.31±102.45）ml，切除盆腔淋巴结（23.41±1.72）枚，切除腹主动脉旁淋巴结（4.13±0.94）枚，术后肛门排气时间（42.63±5.98）h，膀胱功能恢复时间（16.78±4.72）d；1例髂外静脉损伤；所有病例断端及阴道切缘均阴性，术后7例补充放疗、化疗。32例患者术后随访1～48个月，无复发。结论：腹腔镜下宫颈癌根治术安全、可行，疗效满意，但要求术者有熟练的操作技术及处理手术并发症的经验。 　　【关键词】 腹腔镜； 宫颈癌； 广泛子宫切除术； 淋巴结切除术 　　中图分类号 R711.74 文献标识码 B 文章编号 1674-6805（2015）21-0019-02 　　【Abstract】 Objective：To explore the clinical efficacy of laparoscopic radical hysterectomy in the treatment of cervical cancer.Method：A retrospective chart review identified stage Ⅰa2 to Ⅱa cervical cancer patients who underwent laparoscopic radical hysterectomy and pelvic lymph node dissection and abdominal aorta lymph node dissection from January 2011 to November 2014，the treatment effect was observed.Result：All the 32 cases were successfully treated by laparoscopic surgery，no one turned to undergo laparotomy.The mean operative time was （240.06±31.99）min.The average intraoperative blood loss was （245.31±102.45）ml.The average pelvic lymph node resected and abdominal aorta lymph node resected were （23.41±1.72） and （4.13±0.94）.Postoperative anal exhaust time was （42.63±5.98）h，and bladder function recovery time was （16.78±4.72）d.One case complicated with external iliac vein injury.All cases of vaginal stump and cutting edge were negative.Seven cases received supplementary postoperative radiotherapy and chemotherapy.32 cases followed up 1 to 48 months postoperatively no recurrence.Conclusion：Laparoscopic radical hysterectomy for cervical cancer is safe and feasible，and has satisfactory result，but the surgeon must have skilled operation technique and treatment experience of operation complication. 　　【Key words】 Laparoscope； Cervical cancer； Radical hysterectomy； Lymphadenectomy 　　First-author’s address：Shunyi Maternal and Child Care Hospital in Beijing City，Beijing 101300，China 　　doi：10.14033/j.cn