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目的 总结腹腔镜手术治疗子宫恶性肿瘤的临床资料。方法 1999年 8月至 2 0 0 2年 7月对 37例子宫内膜癌 ,15例子宫颈癌行腹腔镜手术 ,其中广泛全子宫切除加双附件切除术 30例 ,广泛全子宫切除加双附件切除加盆腔淋巴结清扫术 2 2例 ;对子宫内膜癌Ⅰb期G2 、G3 的 14例患者同时行腹主动脉旁淋巴结活检术。结果 37例子宫内膜癌全部手术成功 ,无一例出现术中并发症 ,平均手术时间 (2 2 0 4 0± 4 7 89)min ,出血量 (96 6 7±33 39)mL ,术前、后诊断符合率 :Ⅰa期 2 0 0 0 % ,Ⅰb期 6 1 90 % ,术后 3年阴道残端复发 1例 ;15例子宫颈癌患者中 ,中转开腹 1例 ,髂外静脉损伤 2例 ,平均手术时间 (316 11± 6 3 2 4 )min ,出血量 (381 6 7± 74 0 9)mL ,平均切除淋巴结 (18 4 3± 1 6 3)粒 ,术后 1年盆腔侧壁复发 1例。腹腔镜手术治疗子宫恶性肿瘤成功率 98 0 8%。结论 腹腔镜手术治疗子宫恶性肿瘤近期效果良好 ,远期效果有待随访。
Objective To summarize the clinical data of laparoscopic surgery for uterine malignancies. Methods From August 1999 to July 2002, 37 cases of endometrial cancer and 15 cases of cervical cancer underwent laparoscopic surgery. Among them, extensive hysterectomy plus double-attachment resection was performed in 30 cases. A total hysterectomy plus double attachment Resection plus pelvic lymph node dissection in 22 cases; endometrial cancer Ib phase G2, G3 14 cases of patients with abdominal aortic lymph node biopsy at the same time. Results All the 37 cases of endometrial carcinoma were successfully operated. No complications occurred in one case. The average operation time was (22 0 ± 4 7 89) min and the amount of bleeding was (96 6 7 ± 33 39) mL. After the diagnosis, the coincidence rate was 100% in stage Ⅰa and 61 90% in stage Ⅰb, and 1 case was recurred in vaginal stump after 3 years. In 15 cases of cervical cancer, 1 case was converted to laparotomy, 2 cases was external iliac vein injury , Mean operative time (316 11 ± 6 3 2 4) min, blood loss (381 6 7 ± 74 0 9) mL and average number of resected lymph nodes (18 4 3 ± 1 6 3) pellets, pelvic wall recurrence 1 year after operation 1 case. Laparoscopic surgery for the treatment of uterine malignancies 98.8% success rate. Conclusion Laparoscopic surgery for the treatment of uterine malignancies in recent good results, long-term results to be followed up.