腹腔镜下分碎器误用于子宫肉瘤病例的回顾性分析  

A retrospective analysis about laparoscopic morcellator mistakenly applied to uterine sarcoma

作　　者：赵万成[1] 杨清[1] 

机构地区：[1]中国医科大学附属盛京医院妇产科,辽宁沈阳110004

出　　处：《现代肿瘤医学》2015年第23期3507-3510,共4页Journal of Modern Oncology

摘　　要：目的:回顾性分析因子宫肌瘤行腹腔镜手术的病例,探讨分碎器误用于子宫肉瘤的比率以及对其预后的影响。方法:选取2004年11月至2014年11月以诊断为子宫肌瘤入院并行腹腔镜下子宫切除术或子宫肌瘤切除术的患者,统计术后病理确诊或高度怀疑为子宫肉瘤的患者,分析其临床资料并随访其预后。结果:以诊断为子宫肌瘤入院并行腹腔镜子宫切除术或子宫肌瘤切除术的患者,共计2 278例,经术后病理确诊或高度怀疑为子宫肉瘤患者共8例,约占0.35%(8/2278);术后2例病理经上级医院再次复核后考虑为良性,另有一例术后8个月复发行二次手术治疗,术中发现大网膜、肠系膜、腹膜已有多发转移病灶。其余无复发或死亡病例。结论:腹腔镜下分碎器误用于子宫肉瘤的机会非常小,其在腹腔镜子宫肌瘤手术中的应用仍是可行的,但同时应重视分碎器所带来的不良后果并采取措施规避之。Objective： Through the retrospective analysis of the cases of laparoscopic surgery for uterine fibroids,a study was done to investigate the ratio of laparoscopic morcellator mistakenly applied to uterine sarcoma and its influence on prognosis. Methods： From November 2004 to November 2014,those patients,who were admitted to hospital for uterine fibroids and choosed laparoscopic hysterectomy or myomectomy for the first operation,were selected. Among them,the patients diagnosed or suspected with uterine sarcoma by postoperative pathology were selected. Results： The total number of the patients with laparoscopy hysterectomy or myomectomy for uterine fibroids was 2278. Amond them,the number of the patients diagnosed or highly suspected with uterine sarcoma by postoperative pathology was 8,accounts for about 0. 35%（ 8 /2278）. 2 cases were considered as benign by the superior hospital pathology review. Another case accepted the second operation for recurrence after 8 month,and the greater omentum,peritoneum,and mesentery had have multiple lesions. The rest of the cases were without recurrence or death. Conclusion： The opportunity of laparoscopic morcellator mistakenly for uterine sarcoma is very rare. Its application in the laparoscopic surgery can be still feasible,but at the same time we should pay more attention to the adverse consequences brought by the laparoscopic morcellator and take steps to avoid them.

关 键 词：腹腔镜 分碎器 子宫肌瘤 子宫肉瘤 

分 类 号：R713.4[医药卫生—妇产科学] R711.74[医药卫生—临床医学]