早期子宫颈癌行机器人手术系统免举宫器联合经阴道封闭肿瘤广泛性子宫切除术20例分析  

Application of robotic surgical system in radical hysterectomy without lift combined with trans-vaginal tumor closure for cervical cancer at early stage:an analysis of 20 cases

作　　者：付振华 张智[1] 杨蕾[1] 张琦玲 蔡丽萍[1] FU Zhen-hua;ZHANG Zhi;YANG Lei;ZHANG Qi-ling;CAI Li-ping(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Nanchang University,Nanchang 330000,China)

机构地区：[1]南昌大学第一附属医院妇产科,江西南昌330000

出　　处：《中国实用妇科与产科杂志》2020年第9期863-865,共3页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：江西省科技厅基金(2018A057)。

摘　　要：目的探讨机器人手术系统在早期子宫颈癌免举宫器联合经阴道封闭肿瘤广泛性子宫切除术中临床应用效果。方法对2019年1—9月南昌大学第一附属医院收治的20例早期子宫颈癌患者,应用机器人手术系统完成免举宫器联合经阴道封闭肿瘤广泛性子宫切除术,观察治疗效果。结果20例患者均完成机器人手术,无中转开腹及输血,平均手术时间(210.6±20.7)min,平均术中出血量(100.7±30.5)mL,左侧宫旁组织宽度(2.4±0.7)cm,右侧宫旁组织宽度(2.5±0.8)cm,阴道壁组织切除长度(3.1±0.9)cm,清扫淋巴结数目(21.0±6.5)枚。1例髂外血管点状撕裂在腹腔镜下行缝合术止血。术中无输尿管及肠管损伤。术后根据病理结果给予放化疗等辅助治疗,术后随访4~40周患者无死亡及复发。结论早期子宫颈癌行机器人手术系统免举宫器联合经阴道封闭肿瘤广泛性子宫切除术是安全可行的。Objective To analyze clinical utilization of robotic surgical system in radical hysterectomy without lift combined with trans-vaginal tumor closure for cervical cancer at early stage.Methods In 20 cases of early cervical cancer a robotic surgical system was used to complete radical hysterectomy without lift combined with trans-vaginal tumor closure from Jan.to Sep..The treatment effect was observed.Results All 20 patients were successfully operated by robotic surgery,and no case was converted to laparotomy and there was no blood transfusion.Average operation time was(210.6±20.7)min,average intraoperative bleeding was(100.7±30.5)mL,the left parametrium width was(2.4±0.7)cm,the right parametrium width was(2.5±0.8)cm,the length of the vaginal tissue resected was(3.1±0.9)cm and the number of pelvic lymph nodes dissected was(21.0±6.5).One case of external vessel rupture was sewn up under laparoscope to stop bleeding.There was no ureter or bowel injury.After surgery,radiotherapy and/or chemotheray was recommanded according to the pathologic results.After 4 weeks to 40 weeks of follow-up,there was recurrence or death.Conclusion Robotic radical hysterectomy without lift combined with trans-vaginal tumor closure for early-stage cervical cancer is safe and feasible.

关 键 词：机器人手术 早期子宫颈癌 免举宫器联合经阴道肿瘤封闭广泛性子宫切除术 

分 类 号：R737.3[医药卫生—肿瘤]