腹腔镜在子宫颈癌治疗中的应用--附37例分析

目的　探讨腹腔镜下广泛子宫切除和盆腹腔淋巴结切除治疗子宫颈癌的可行性及价值。　方法　采用腹腔镜下广泛子宫切除和盆腔及腹主动脉周围淋巴结切除治疗 37例子宫颈癌。其中有2 5例选择性腹主动脉周围内淋巴结切除。　结果　腹腔镜下手术时间平均 182min ,术中出血平均16 8ml,切除淋巴结数平均 16个 ,术后住院平均 10 2天。术中发生膀胱损伤 1例、静脉损伤 2例 ,均于镜下修补成功 ;1例损伤大肠中转开腹 ;2例出现尿潴留。　结论　腹腔镜下施行广泛子宫切除和盆腹腔淋巴结切除术安全可行 ,且手术创伤小 ,并发症少 ,术后恢复快。

The Application of laparoscopic lymphadenectomy in the treatment of cervical carcinoma

Objective To investigate the feasibility and value of laparoscopic radical hysterectomy and lymphadenectomy in patients with cervical carcinoma. Methods From July 2000 to June 2002, We underwent laparoscopic radial hysterectomy and lymphadenectomy on 37 patients with early stage cervical carcinoma proven by biopsy.Pelvic, para-aortic and combination of both pelvic and para-aortic lymphadenectomy were performed on 25 patieuts.Radical hysterectomy was performed immediately if residual nodes were negative. Results All but 1 surgical procedures were completed laparoscopically. An average of operation time was 182 min. An average blood loss was 168ml. An average number of lymph nodes was 16. An average hospital stay was 10.2 days. Intraoperative complications were found in 4 cases, including one case with bladder injury and other two cases with venues injury and one case with colon injury who was converted into open-operation. Two cases had urinary retention. Conclusions Laparoscopic vaginal radical hysterectomy and lymphadenectomy are feasible and safe for the treatment of cervical carcinoma. Also it has advantages of minimal invasion, less complications and quicker recovery.