一次性使用内窥镜标本取物袋在腹腔镜子宫(肌瘤)分碎术中应用的有效性与安全性分析  

Efficacy and Safety of Disposable Endoscopic Retriever Bag in Laparo-scopic Morcellation

作　　者：石宇 刘红 张国楠 黄静 王登凤 史洵玮 余健 Shi Yu;Liu Hong;Zhang Guonan;Huang Jing;Wang Dengfeng;Shi Xunwei;Yu Jian(Gynecologic Oncology Center,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China;Surgery Center,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China)

机构地区：[1]四川省肿瘤医院·研究所,四川省癌症防治中心,电子科技大学医学院妇科肿瘤中心,成都610041 [2]四川省肿瘤医院·研究所,四川省癌症防治中心,电子科技大学医学院手术室,成都610041

出　　处：《肿瘤预防与治疗》2020年第5期395-400,共6页Journal of Cancer Control And Treatment

基　　金：四川省医学重点学科建设项目(编号:川卫办发[2007]407号)。

摘　　要：目的:探讨一次性使用内窥镜标本取物袋(密闭式分碎袋)在腹腔镜子宫(肌瘤)分碎术中应用的有效性与安全性。方法:选取2018年3月至2019年12月在我院妇科肿瘤中心的51例子宫肌瘤患者作为研究对象,分析其人口统计学基本信息、手术情况及术后并发症,评估术中使用密闭式分碎袋的应用价值。结果:51例患者的平均年龄(44.8±4.5)岁(范围39~49岁);平均体重指数(22.4±5.6) kg/m^2(范围16.6~27.2 kg/m^2);平均子宫大小孕(14.1±3.2)周(范围孕10~20周)。所有患者均在密闭式分碎袋中成功进行并完成分碎术,手术平均时间为(136.5±86.3)min(范围95~310 min);放置密闭式分碎袋、穿刺器导管及标本置入的平均时间为(22.1±8.9) min(范围18~45 min);病灶分碎的平均时间为(33.5±6.5)min(范围20~55 min);病灶取出的平均时间为(9.3±3.7) min(范围5~15 min);处理密闭式分碎袋的平均时间为(15.4±8.2) min(范围8~25 min)。术中平均出血量为(64.5±27.8) mL(范围20~150 mL);子宫平均重量为(433.8±204.3) g(范围290~980 g);无手术并发症和密闭式分碎袋意外破裂发生;术前术后腹腔冲洗液中均未查见梭形细胞或恶性肿瘤细胞。结论:腹腔镜子宫(肌瘤)分碎术中使用一次性使用内窥镜标本取物袋(密闭式分碎袋)能安全且有效地预防分碎术所致的细胞或组织播散种植,值得临床推广应用。Objective:To explore the clinical application of disposable endoscopic retriever bag in laparoscopic morcellation for fibroids.Methods:Demographic information,operation conditions and postoperative complications of 51 patients with fibroids in our gynecologic cancer center from March 2018 to December 2019 were selected and analyzed,and the application value of endoscopic retriever bags used in operations was evaluated.Results:The average age of the 51 patients was(44.8±4.5)years(39-49 years);the mean body mass in-dex was(22.4±5.6)kg/m2(16.6-27.2 kg/m2);the mean uterine size was(14.1±3.2)weeks(10-20 weeks).Laparoscopic in-bag morcellation was successfully conducted for all patients.The average operation time was(136.5±86.3)min(95-310 min);the average time for placing the endoscopic retriever bag plus the puncture catheter plus the speci-men in a morcellation was(22.1±8.9)min(18-45 min);the average time for crushing foci was(33.5±6.5)min(20-55 min);the average time for retrieving foci was(9.3±3.7)min(5-15 min);the average time for handling en-doscopic retriever bags was(15.4±8.2)min(8-25 min).The average hemorrhage volume was(64.5±27.8)mL(20-150 mL);the average weight of uterus was(433.8±204.3)g(290-980 g).Operative complications and acci-dental rupture of endoscopic retriever bags were not observed.No spindle cells or malignant cells were found in the peritoneal lavage cytology before and after operation.Conclusion:It is safe and effective to use disposable endoscopic retriever bag in laparoscopic morcellation.

关 键 词：内窥镜标本取物袋 子宫肌瘤 腹腔镜下子宫(肌瘤)分碎术 

分 类 号：R737.33[医药卫生—肿瘤] R730.56[医药卫生—临床医学]