“垂钓式”子宫悬吊联合阴道荷包缝合包埋宫颈的腹腔镜广泛性子宫切除术  

Laparoscopic Radical Hysterectomy With“Fishing-style”Uterine Suspension and Vaginal Purse-string Suture Encapsulation of the Cervix for Cervical Cancer

作　　者：王苗苗 李秀芳[1] 黄相艳[1] 孟泳圳[1] Wang Miaomiao;Li Xiufang;Huang Xiangyan(Department of Gynecological Oncology,Anyang Tumor Hospital,Anyang 455000,China)

机构地区：[1]河南省安阳市肿瘤医院妇瘤科,安阳455000

出　　处：《中国微创外科杂志》2024年第7期473-478,共6页Chinese Journal of Minimally Invasive Surgery

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210878)。

摘　　要：目的探讨“垂钓式”子宫悬吊联合阴道荷包缝合包埋宫颈的改良腹腔镜广泛性子宫切除术的安全性及有效性。方法回顾性分析2021年10月~2023年8月82例Querleu-Morrow分型C2型广泛性子宫切除术资料,其中36例腹腔镜手术(腹腔镜组),46例开放手术(开放组)。腹腔镜组采用“垂钓式”子宫悬吊避免使用举宫杯,阴道荷包缝合包埋宫颈后切开阴道壁。比较2组手术时间、术中出血量、并发症、病理切缘阳性率及复发率。结果腹腔镜组术中出血量、术后住院时间明显少于开放组[40(30~130)ml vs.80(20~300)ml,Z=-4.057,P=0.000;8.5(5~24)d vs.10(5~26)d,Z=-2.975,P=0.003];2组手术时间、并发症发生率、淋巴结切除个数、切缘阳性率、复发率差异均无统计学意义(P>0.05)。结论“垂钓式”子宫悬吊联合阴道荷包缝合包埋宫颈的改良腹腔镜广泛性子宫切除术治疗早期宫颈癌安全有效。Objective To explore the safety and efficacy of“fishing-style”uterine suspension and vaginal purse-string suture encapsulation of the cervix in modified laparoscopic radical hysterectomy.Methods Clinical data of 82 patients with cervical cancer who underwent QM-C2 radical hysterectomy in our hospital from October 2021 to August 2023 were retrospectively analyzed.There were 36 cases in laparoscopic group(LRH)and 46 cases in abdominal group(ARH).In the laparoscopic group,the“fishing-style”uterine suspension,rather than a uterine manipulator,was used to manipulate the uterus,followed by vaginal purse-string suture encapsulation of the cervix before copotomy.The operation time,intraoperative bleeding,complications,positive rate of pathological margins,and recurrence rate were compared between the two groups.Results The LRH group showed less intraoperative bleeding and shorter postoperative hospital stay than the ARH group[40(30-130)ml vs.80(20-300)ml,Z=-4.057,P=0.000;8.5(5-24)d vs.10(5-26)d,Z=-2.975,P=0.003].There were no significant differences in operation time,complications,the number of lymph node dissected,cutting edge positivity rate,and recurrence rate(P>0.05).Conclusion The modified laparoscopic radical hysterectomy with“fishing-style”uterine suspension and vaginal purse-string suture encapsulation of the cervix is safe and feasible.

关 键 词：宫颈癌 腹腔镜 广泛性子宫切除术 子宫悬吊法 

分 类 号：R737.33[医药卫生—肿瘤]