经自然腔道内镜手术在妇科恶性肿瘤中的应用

微创治疗对妇科肿瘤有重要意义。单孔腹腔镜手术（LESS）与经自然腔道内镜手术（NOTES）是微创治疗领域最新发展起来的技术。目前多种妇科良性手术均可以经LESS或NOTES完成，并取得了良好的临床疗效。妇科恶性肿瘤手术较为复杂，LESS与NOTES用于妇科恶性肿瘤的治疗尚有争议，目前国内外学者对NOTES用于恶性肿瘤的治疗已经进行了一些有益的尝试，初步数据证实了该术式的可行性，但是由于操作空间小，造成操作难度较大，手术操作技巧仍有待开发。文章结合笔者单位初步探索的经验，对NOTES在妇科恶性肿瘤中应用的现状、优势、困难与技术经验进行阐述。

Application of natural orifice transluminal endoscopic surgery in gynecological malignant tumors.

Minimally invasive treatment is of great significance to gynecological tumors.Laparoendoscopic single-site surgery（LESS）and natural orifice transluminal endoscopic surgery（NOTES）are recent advances in the field of minimally invasive treatment.At present，a variety of gynecological benign surgery can be managed by LESS or NOTES surgery，and achieved good clinical results.Operation for gynecologic malignancies are complicated，and LESS and NOTES surgery are still controversial for the treatment of gynecologic malignancies.At present，domestic and foreign scholars have made some useful attempts to apply NOTES surgery to malignant tumors.Preliminary data have confirmed the feasibility of these procedure，but due to the small operating space，the operation is difficult，and the operation skills still need to be developed.Based on the experience of our hospital's initial exploration，this article briefly explains the current situation，advantages，difficulties and technical experience in the application of NOTES surgery for gynecological malignancies.