改良Nathanson术联合阴式广泛性子宫切除术在宫颈癌治疗中的应用  

Application of Transvaginal Radical Hysterectomy and Modified Nathanson's Extraperitoneal Pelvic Lymphadenectomy in Treatment of Invasive Cervical Cancer

作　　者：陆安伟[1] 王建三[1] 李智[1] 

机构地区：[1]贵阳市妇幼保健院,贵州贵阳550003

出　　处：《实用妇产科杂志》2008年第7期420-422,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨改良腹膜外淋巴结清扫术及阴式广泛性子宫切除术在浸润型宫颈癌治疗中的应用价值。方法:2004年10月至2006年10月,我们对18例ⅠA2期至ⅡA期的宫颈癌患者实施了经腹的腹膜外淋巴结清扫术及经阴道广泛子宫切除术。腹部淋巴结清扫的单侧切口长约5 cm。在经阴道的广泛子宫切除术时,无需行Schuchardt切口,而是首先切除宫骶韧带,再游离输尿管。结果:18例手术均获成功,平均手术时间212±20.32分钟,平均出血量530±35.12ml,平均术后肛门排气时间26±4.15小时,平均清扫盆腔淋巴结数目31±2.23个。术后无尿潴留发生。结论:改良腹膜外盆腔淋巴结清扫术及经阴道广泛子宫切除术安全可行;并可先于输尿管游离之前,切除宫骶韧带,有利于充分暴露术野,有利于打开输尿管隧道。Objectlve： To investigate the clinical value of miniincision extraperitorieal lymphadenectomy and transvaginal radical hysterectomy in treating invasive cervical carcinoma. Methods;We performed mini- incision extraperitoneal lymphadenectomy and transvaginal radical hysterectomy on 18 patients with stage ⅠA2 - ⅡA cervical carcinoma from Oct. 2004 to Oct. 2006, The length of unilateral abdominal incision is about 5cm. The transvaginal radical hysterectomy was performed without Schuchardt＇ s episiotomy, as the uterosecral ligaments ware ablated before ureters dissection. Results： Eighten cases underwent this operation successfully. The average operative - time, blood loss and bowel functional recovering time ware 212min, 530ml and 26h respectively. The mean number of lymph-nodes cleared was 31. There was no postoperative uroschesis. Conclusions. Mini- incision extraperitoneal pelvic lymphadenectomy and transvaginal radical hYSterectomy has many advantages, which is a worthful way in treating invasive cervical carcinoma.

关 键 词：腹膜外 盆腔淋巴结清扫术 阴式广泛性子宫切除术 宫颈癌根治术 

分 类 号：R737.33[医药卫生—肿瘤]