腹腔镜广泛子宫切除及盆腔淋巴结清扫术治疗宫颈癌的并发症分析  

Analysis of Laparoscopic Radical Hysterectomy and Pelvic Lymphadenectomy in Treatment of Complications of Cervical Cancer

作　　者：陈日笑[1] 张晓薇[1] 

机构地区：[1]广州医科大学附属第一医院妇产科,广东广州510120

出　　处：《中外医疗》2015年第36期83-85,共3页China & Foreign Medical Treatment

摘　　要：目的探讨腹腔镜广泛子宫切除（LRH）及盆腔淋巴结清扫术（LPL）治疗宫颈癌的近期临床疗效。方法回顾性分析整群选取2010年4月—2014年6月间该院收治的96例Ia2～IIIa宫颈癌LRH及LPL术中及术后观察。结果93例患者成功在腹腔镜下完成手术,3例中转开腹。手术时间228～330 min,平均278 min。术中出血量50～500 m L,平均183 m L;切除盆腔淋巴数11～67枚,平均29.7枚。术后胃肠功能恢复时间1.5～3 d,平均2.6 d。该研究中患者恢复自主排尿的中位时间为26.3 d,术中并发症1例血管损伤;术后主要并发症10例,1例输尿管狭窄,4例下肢静脉血栓形成,4例淋巴囊肿,1例盆腔脓肿;晚期并发症有26例膀胱功能障碍。结论腹腔镜下广泛子宫切除及盆腔淋巴结清扫术治疗宫颈癌,术式安全有效,并发症发生率和中转开腹率低,可以作为宫颈癌治疗的常规术式。Objective To study the short-term clinical curative effect of laparoscopic radical hysterectomy and pelvic lymphadenectomy in treatment of cervical cancer. Methods 96 cases of patients with cervical cancer from Ia2 stage to IIIa stage admitted and treated in our hospital from April 2010 to June 2014 were selected and their data were retrospectively analyzed, the patients were treated with LRH and LPL, and the intraoperative and postoperative conditions were observed. Results 93 cases of patients had successfully finished operation under laparoscope, 3 cases were converted to laparotomy, the operation time was 228-330 min, 278 min averagely, the intraoperative blood loss was 50-500 ml, 183 ml averagely, the excision number of pelvic lymph was 11-67, 29.7 averagely, the recovery time of postoperative gastrointestinal function was1.5-3d, 2.6d averagely, in this study, the medium time of the recovery of automatic micturition of patients was 26.3d, 1case was complicated by vascular injury in operation, and complications occurred to 10 cases after operation, ureterostenosis occurred to 1 case, deep venous thrombosis occurred to 4 cases, lymphocele occurred to 4 cases, pelvic abscess occurred to1 case, and 26 cases were complicated by bladder dysfunction in late stage. Conclusion Laparoscopic radical hysterectomy and pelvic lymphadenectomy in treatment of cervical cancer is safe and effective with low incidence of complications and rate of conversion to laparotomy, which can be used as the conventional operation method of cervical cancer treatment.

关 键 词：宫颈癌 腹腔镜 广泛子宫切除术 淋巴清扫术 并发症 

分 类 号：R5[医药卫生—内科学]