子宫内膜癌行腹腔镜下腹主动脉旁淋巴结清扫术中十二指肠损伤的外科处理  

作　　者：厉瑶 张琳 郑顺杰 陈盼 

机构地区：[1]浙江大学医学院附属金华医院,321000

出　　处：《浙江临床医学》2022年第5期693-694,共2页Zhejiang Clinical Medical Journal

摘　　要：目的 分析子宫内膜癌行腹腔镜下腹主动脉旁淋巴结清扫术中十二指肠损伤的发生原因和外科处理方法.方法 回顾性分析2012年3月至2020年12月因子宫内膜癌实施腹腔镜下腹主动脉旁淋巴结清扫术中发生十二指肠损伤5例患者的临床资料.结果 5例患者平均年龄53.6岁.其中十二指肠降段损伤2例,水平段损伤3例.浆肌层破裂1例,全层裂伤4例.5例患者均在腹腔镜下行十二指肠缝合修补术,无中转剖腹.中位手术时间251(235,330)min.术后患者恢复良好,均治愈,平均住院时间11.2 d.术后并发胸腔积液1例,轻度腹泻1例.结论 早期发现和选择合适的处理方法是提高腹腔镜下腹主动脉旁淋巴结清扫术中发生十二指肠损伤后治愈率的关键,规范的手术操作可以有效预防医源性十二指肠损伤的发生.Objective To investigate the causes and surgical treatment of duodenal injury during laparoscopic para-aortic lymph node dissection for endometrial carcinoma.Methods We have collected and retrospectively analyzed the clinical data of 5 patients who underwent duodenal injury during laparoscopic para-aortic lymph node dissection from March 2012 to December 2020 at Affiliated Jinhua Hospital,Zhejiang University School of Medicine.Results The average age of 5 patients was 53.6 years.There were 2 patients of duodenal descending segment injury and 3 patients of horizontal segment injury.There were 1 case of rupture of serous muscle layer and 4 cases of total laceration.All 5 patients underwent direct repair of duodenum by laparoscopy without transection.The median duration was 251(235,330)min.The patients recovered well and all cured,and the average hospital stay was 11.2 days after operation.Two patients occurred postoperative complicarions,including one pleural efiiision and one diarrhea.Conclusion Early detection and selecrion of appropriate treatment is the key to improve the cure rate of duodenal injury in laparoscopic para-aortic lymph node dissection.The standard operation can effectively prevent the occurrence of iatrogenic duodenal injury.

关 键 词：腹主动脉旁淋巴结 十二指肠损伤 腹腔镜 

分 类 号：R73[医药卫生—肿瘤]