腹腔镜下旋切器误用于子宫肉瘤6例分析并文献复习  

Analysis and Literature Review of Laparoscopic Rotary Cutting is Mistakenly Used in 6 Cases of Uterine Sarcoma

作　　者：武化拓 马焱[1] 李莉[1] WU Hua-tuo MA Yan LI Li.(Department of Gynecology, Tumor Hospital Affiliated to Xinjiang Medical University, Urumchi 830011, China)

机构地区：[1]新疆医科大学附属肿瘤医院妇科,乌鲁木齐830011

出　　处：《国际妇产科学杂志》2017年第3期307-311,共5页Journal of International Obstetrics and Gynecology

摘　　要：目的:探讨旋切器误用于子宫肉瘤的概率,以及应用旋切器对子宫肉瘤患者预后的影响。方法:查阅2010年1月—2015年12月新疆医科大学附属肿瘤医院妇科以诊断子宫肌瘤入院并行腹腔镜下子宫肌瘤剔除术(均应用旋切器进行辅助肌瘤剔除)的患者资料,统计其术后病理为子宫肉瘤的患者,并随访其预后。结果:以子宫肌瘤为诊断入院并行子宫肌瘤粉碎术的患者共1 886例,其中术后病理诊断为子宫肉瘤者6例;其中1例患者再次手术时发现盆腔及大网膜转移病灶;1例患者化疗后进展死亡;1例患者半年后复发,2年后死亡;其余3例患者随访至今未复发。结论:子宫肌瘤旋切器误用于子宫肉瘤的概率非常小,约为0.31%(6/1 886)。子宫肌瘤旋切器仍是可行的手术器械,但应注意应用旋切器所带来的不良后果,并采取合适措施来规避。Objective To investigate the probability of mistaken use of the rotator in uterine sarcoma and the effect of peeling device on the prognosis of patients with uterine sarcoma. Methods： Refer to the patients who have been diagnosed as uterine fibroids and undergone hospitalized laparoscopic myomectomy in Xinjiang Medical University Cancer Hospital gynecology from January 2010 to December 2015, collect the patients whose postoperative pathology was uterine sarcoma. Rotary cutting device were used in these patients and its prognosis was followed up. Results： A total of 1 886 patients have been diagnosed as uterine fibroids and undergone hospitalized laparoscopic myomectomy with rotary cutting device, including postoperative pathological diagnosis of uterine sarcoma patients in 6 cases. One patient underwent surgery and find pelvic and omental metastatic lesions; one patient dead after chemotherapy; one patient relapsed after six months and died two years later. The remaining three patients were followed up and did not relapse until now. Conclusions： The probability of uterine leiomyosarcoma misuse for uterine sarcoma is very small, about 0.31% （6/1 886）, uterine fibroids peeling device is still afeasible surgical instrument for uterine fibroids, but we should pay attention to the negative consequences of the rotary cutting device, and take appropriate measures to avoid it.

关 键 词：子宫肿瘤 平滑肌瘤 腹腔镜检查 肉瘤 外科设备 

分 类 号：R737.33[医药卫生—肿瘤]