本文關(guān)鍵詞： 意外發(fā)現(xiàn)宮頸癌 腹腔鏡廣泛宮旁切除術(shù) 預(yù)后　出處：《中國微創(chuàng)外科雜志》2016年04期 　論文類型：期刊論文

【摘要】：目的探討腹腔鏡廣泛宮旁切除術(shù)治療意外發(fā)現(xiàn)宮頸癌(unexpected cervical cancer)的安全性及臨床療效。方法回顧性分析2008年1月~2014年12月意外發(fā)現(xiàn)宮頸浸潤癌15例臨床資料,年齡29~67歲,平均43.9歲,切除子宮的手術(shù)指征分別為高級別宮頸上皮內(nèi)瘤變7例,子宮肌瘤3例,功能失調(diào)性子宮出血2例,子宮脫垂2例,子宮腺肌癥1例。首次手術(shù)病理類型宮頸鱗癌13例,腺癌2例;15例病灶均局限于宮頸,其中ⅠA2期4例,ⅠB1期11例;4例淋巴血管間隙浸潤(lymph-vascular space invasion,LVSI)。兩次手術(shù)間隔時間3~7 d,平均4.6 d。均行腹腔鏡廣泛宮旁切除術(shù)。結(jié)果手術(shù)時間212~285 min,平均249.6 min;術(shù)中出血量250~500 ml,平均376 ml;術(shù)后病理結(jié)果 15例均未見癌殘留,1例左側(cè)盆腔淋巴結(jié)陽性。術(shù)中并發(fā)癥2例,包括膀胱損傷1例、輸尿管損傷1例;術(shù)后并發(fā)癥3例,包括尿潴留2例、淋巴囊腫1例。隨訪時間6~84個月,中位數(shù)48個月,無一例復(fù)發(fā),1、3、5年生存率分別為100%、93.3%、86.7%。結(jié)論對于意外發(fā)現(xiàn)宮頸癌,行腹腔鏡下廣泛宮旁切除術(shù)操作難度大,技術(shù)要求高,并發(fā)癥多,適用于拒絕術(shù)后放療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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