腹腔镜妇科恶性肿瘤手术25例临床体会  

Clinical experience of laparoscopic surgery for gynecologic malignancy in 25 cases

作　　者：万晨东 朱晨燕 徐云 郑丽萍 童元枝 李敏 WAN Chen-dong;ZHUChen-yan;XU Yun;ZHENG Li-ping;TONG Yuan-zhi;LI Min(Department of Obstetrics and Gynecology, Fourth People'sHospital of Yixing City, Yixing 214200, Jiangsu, CHINA)

机构地区：[1]宜兴市第四人民医院妇产科,江苏宜兴214200

出　　处：《海南医学》2019年第10期1322-1325,共4页Hainan Medical Journal

摘　　要：目的探讨开展腹腔镜下妇科恶性肿瘤手术的安全性、有效性和可行性。方法回顾性分析2013年5月至2018年12月在宜兴市第四人民医院妇产科接受腹腔镜妇科恶性肿瘤手术的25例患者的临床资料。结果 25例患者中接受腹腔镜宫颈癌根治术9例,腹腔镜子宫内膜癌分期手术10例,腹腔镜卵巢肿瘤分期手术5例,腹腔镜子宫肉瘤手术1例,无一例中转开腹。术后随访,1例宫颈鳞癌ⅡA1期,术后病理盆腔淋巴结6枚阳性,术后拒绝补充放化疗,失访,追踪得知患者一年后死亡。1例子宫内膜低分化腺癌ⅢC1期,盆腔淋巴结5枚阳性,术后补充放化疗,一年半肿瘤远处转移,现在后续治疗中。其余患者均未发现异常,继续随访中。结论严格按照肿瘤规范,正确把握手术适应证,不断提高手术操作技能,掌握手术要点以及并发症防治技巧,开展腹腔镜下妇科恶性肿瘤手术是安全、可行的。Objective To explore the safety, effectiveness, and feasibility of laparoscopic surgery for gynecologic malignancy. Methods The clinical data of 25 patients with gynecological malignant tumors who underwent laparoscopic surgery in Fourth People’s Hospital of Yixing from May 2013 to December 2018 were analyzed retrospectively.Results Of the 25 patients, 9 underwent laparoscopic radical resection of cervical cancer, 10 underwent laparoscopic staging of endometrial cancer, 5 underwent laparoscopic staging of ovarian tumor, and 1 underwent laparoscopic surgery for uterine sarcoma. During the postoperative follow-up, 1 case of cervical squamous cell carcinoma in stage ⅡA1 with6 positive pathological pelvic lymph nodes after surgery refused to receive radiotherapy and chemotherapy after surgery and was lost to follow-up, who died one year later;1 case of endometrial poorly differentiated adenocarcinoma in stage Ⅲ C1 with 5 positive pelvic lymph nodes received radiotherapy and chemotherapy after surgery, and was found with distant metastasis in one and a half years, which was now undergoing follow-up treatment. No abnormalities were found in the remaining patients, and follow-up was continued. Conclusion It is safe and feasible to carry out laparoscopic surgery for gynecological malignant tumors by strictly following the tumor standard, correctly grasping the operation indications, continuously improving the operation skills, mastering the key points of operation and the prevention and treatment of complications.

关 键 词：腹腔镜 妇科恶性肿瘤 手术要点 并发症 防治 可行性 

分 类 号：R737.3[医药卫生—肿瘤]