经腹根治性宫颈切除保留子宫动脉的两种术式  

Abdominal Radical Trachelectomy: Two New Surgical Techniques for the Conservation of Uterine Arteries

作　　者：万小平[1] 席晓薇[1] 严沁[1] 祝亚平[1] 刘新民[2] 

机构地区：[1]上海交通大学附属第一人民医院,上海200080 [2]山东省立医院,山东济南250021

出　　处：《实用妇产科杂志》2005年第11期682-685,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:设计和评估经腹根治性宫颈切除术中保留子宫动脉的两种术式。方法:2例宫颈鳞癌ⅠB1期患者经腹根治性宫颈切除术时分别采用髂内动脉切断和再吻合术和髂内动脉-子宫动脉完全游离术两种不同的保留子宫动脉的术式。观察术中、术后情况。结果:两种手术经过顺利,无术中和术后并发症。两种手术的持续时间分别为390分钟和350分钟;术中出血量分别约600ml和400ml,均未输血。第1种术后左右两侧的子宫动脉的阻力指数分别为0.58和0.61,第2种分别为0.60和0.63。结论:经腹根治性宫颈切除术中使用“髂内动脉切断—再吻合术”或“髂内动脉-子宫动脉完全游离术”以保留子宫动脉的子宫体血供均是可行的方法,而第二种术式避免了复杂的显微血管技术,更易于操作与推广。Objective：To develop and evaluate two new techniques for the conservation of uterine arteries in abdominal radical trachelectomy. Methods：The abdominal trachelectomy and pelvic lymphadenectomy with conservation of uterine arteries were performed in two patients who had cervical squamous carcinoma with FIGO stage Ⅰ B1. Results： The two patients underwent the planned procedure with no intraoperative or postoperative complications. The operative time of the two patients was 390 min. and 350 min. respectively. Blood loss during operation was 600ml in the first case, 400ml in the second case. No blood transfusion was needed. Doppler flow studies demonstrated that the uterine arteries were patent in both cases. Resistance index of the left and the right uterine artery was 0.58 and 0.61 respectively in the first case, 0.60 and 0.63 respectively in the second case.Concluslons：Application of “re-anastomosis of internal iliac arteries” or “skeletonisation of the internal iliac arteries and uterine arteries” for the conservation of uterine arteries in the abdominal radical trachlectomy is feasible.

关 键 词：根治性宫颈切除术 宫颈鳞癌 生育 子宫动脉 

分 类 号：R737.33[医药卫生—肿瘤]