腹腔镜广泛宫旁切除术治疗意外发现宫颈癌

发布时间：2018-02-22 05:10

  本文关键词： 意外发现宫颈癌 腹腔镜广泛宫旁切除术 预后　出处：《中国微创外科杂志》2016年04期 　论文类型：期刊论文

【摘要】：目的探讨腹腔镜广泛宫旁切除术治疗意外发现宫颈癌(unexpected cervical cancer)的安全性及临床疗效。方法回顾性分析2008年1月~2014年12月意外发现宫颈浸润癌15例临床资料,年龄29~67岁,平均43.9岁,切除子宫的手术指征分别为高级别宫颈上皮内瘤变7例,子宫肌瘤3例,功能失调性子宫出血2例,子宫脱垂2例,子宫腺肌症1例。首次手术病理类型宫颈鳞癌13例,腺癌2例;15例病灶均局限于宫颈,其中ⅠA2期4例,ⅠB1期11例;4例淋巴血管间隙浸润(lymph-vascular space invasion,LVSI)。两次手术间隔时间3~7 d,平均4.6 d。均行腹腔镜广泛宫旁切除术。结果手术时间212~285 min,平均249.6 min;术中出血量250~500 ml,平均376 ml;术后病理结果 15例均未见癌残留,1例左侧盆腔淋巴结阳性。术中并发症2例,包括膀胱损伤1例、输尿管损伤1例;术后并发症3例,包括尿潴留2例、淋巴囊肿1例。随访时间6~84个月,中位数48个月,无一例复发,1、3、5年生存率分别为100%、93.3%、86.7%。结论对于意外发现宫颈癌,行腹腔镜下广泛宫旁切除术操作难度大,技术要求高,并发症多,适用于拒绝术后放疗及要求保留卵巢功能者。
[Abstract]:Objective to investigate the safety and clinical efficacy of laparoscopic extensive paracervical resection in the treatment of cervix carcinoma. Methods from January 2008 to December 2014, 15 patients with invasive carcinoma of cervix were retrospectively analyzed, aged 2967 years with an average of 43.9 years. The operative indications of hysterectomy were high grade cervical intraepithelial neoplasia in 7 cases, uterine leiomyoma in 3 cases, dysfunctional uterine bleeding in 2 cases, uterine prolapse in 2 cases, adenomyosis in 1 case. In 2 cases of adenocarcinoma, 15 cases were located in the cervix, of which 4 cases were in stage 鈪，

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