摘要
目的：探讨腹腔镜技术应用于妇科恶性肿瘤手术-病理分期手术的可行性及安全性。方法：应用腹腔镜对经病理证实的子宫内膜癌（36例）、卵巢癌（7例）和输卯管癌（1例）行手术-病理分期手术。结果：44例腹腔镜手术顺利，手术时间平均145（120～180）min。术中出血量平均140（100～200）ml，术中术后均未输血。未发生手术并发症。平均每例切除主动脉旁淋巴结5（0～9）枚、盆腔淋巴结19（10～28）枚。子宫内膜癌的手术病理分期结果：子宫内膜样腺癌Ⅰ期26例，Ⅱa期1例，Ⅲa期3例（盆腔积液细胞学阳性），子宫内膜癌肉瘤Ⅱ期1例，子宫内膜乳头状腺癌Ⅰb期2例，子宫颈癌肉瘤Ⅰ期1例，子宫内膜腺癌（部分肉瘤样变）Ⅲa期1例，子宫内膜腺棘皮癌Ⅰ期1例。7例卵巢癌和1例输卵管乳头状腺癌再分期术后病理均无阳性发现。44例患者术后随访9～22个月，无电凝损伤、淋巴囊肿及下肢运动与功能障碍发生。结论：应用腹腔镜进行妇科恶性肿瘤手术-病理分期手术是安全、可行的，可作为临床进行妇科恶性肿瘤手术-病理分期手术的一种手术选择。
Objective： To investigate the feasibility of laparoscopic modifled radical hysterectomy and abdomino pelvic lymphadenectomy in the treatment of malignant uterine tumors. To explore the safety and effective of laparoseopic operation as treatment for surgical staging of endometrial carcinoma and ovarian carcinoma. Methods： Laparoscopic extensive total hysterectomy and pelvic lymphadenectomy were performed in 44 cases of earlystage malignant uterine tumors. There were 36 cases with endometrial cancer and 7 cases with ovarian, carcinoma and one with salpingian cancer. Results. The operation was completed under laparoscope in 44 cases. All the operations were successfully completed and no complication was observed. The operation time was 120 - 180 （mean, 145） min; the intraoperative hemorrhage volume was 100 - 200 （mean,140） ml; the number of excised lymphnodes was 10-28 （mean,19）. The surgical staging of endoinertial carcinoma： Stage Ⅰ of endometrial adenocarcinoma 26 cases; Stage Ⅱ 3 cases （peritoneal positive cytology）. StageⅡ of endometroid sarcoma 1 case; stage Ⅰ b of endometriod papilliferous adenocarcinoma 2 cases; stage Ⅰ of cervical carcinosarcoma; StageⅢ a of endometriod adenocareinoma （partly changing into sarcoma） 26 cases; Stage Ⅰ of endometriod adeno-acanthoma 1 case. No positive pathological finding in second-staging operations in seven cases of ovarian cancer and one case papilliferous adenocarcinoma of fallopian tube. No electric damagement,lymphatic cyst and dysfunction of lower limbs by follow-up investigation in 9-22 months in 44 eases. Conclusions： Laparoscopicmodifled radical hysterectomy and pelvic/paraaotic nodes dissection and omentectomy and appendicectomyl for the endometria and Ovarian cancer is safe, feasible, effective, and reliable.
出处
《新疆医科大学学报》
CAS
2008年第7期838-840,共3页
Journal of Xinjiang Medical University
