腹腔镜手术治疗妇科恶性肿瘤48例临床分析

摘要

目的：探讨腹腔镜手术治疗妇科恶性肿瘤的临床疗效。方法：2011年1月-2014年7月，本院应用腹腔镜手术治疗48例妇科恶性肿瘤（子宫内膜癌23例，子宫肉瘤1例，子宫颈癌19例，宫颈残端癌1例，卵巢癌2例，复发性卵巢癌1例，子宫内膜和卵巢原发性双癌1例），观察腹腔镜手术治疗效果。结果：48例手术均成功，无一例中转开腹。手术时间平均（249.29±71.83）min，术中出血量平均（237.50±132.95）mL，盆腔淋巴结平均切除（18.61±3.06）枚，腹主动脉旁淋巴结平均切除（4.07±1.42）枚。2例髂外静脉损伤，1例膀胱损伤。48例患者术后随访3~45个月，1例低分化宫颈腺鳞癌Ⅱa期盆腔淋巴结阳性患者，术后9个月复发，放弃治疗6个月死亡，其余47例均无复发。结论：腹腔镜手术治疗妇科恶性肿瘤安全、可行，疗效满意，但要求术者有熟练的操作技术及处理手术并发症的经验。%Objective:To explore the clinical efficacy of laparoscopic surgery for the treatment of gynecological malignancies.Method:A total of 48 patients with malignant tumors including 23 cases with endometrial cancer,1 case with uterine sarcoma,19 cases with cervical cancer,1 case with residual cervical cancer,2 cases with ovarian cancer,1 case with recurrent ovarian cancer and 1 case with synchronous primary cancers of the endometrium and ovary in our hospital from January 2011 to July 2014 underwent laparoscopic surgery.The laparoscopic surgery treatment effect was observed.Result:All the 48 cases were successfully treated by laparoscopic surgery,no one turned to undergo laparotomy.The average operation time was (249.29±71.83)min.The average intraoperative hemorrhage volume was (237.50±132.95)mL.The average pelvic lymph node resected and abdominal aorta lymph node resected were(18.61±3.06) and (4.07±1.42).2 patients complicated with external iliac vein injury.1 patient complicated with bladder injury.Follow up checkups for 3-45 months postoperatively in 48 patients showed 1 case of recurrence at 9 postoperative month(stage Ⅱa cervical adenosquamous carcinoma and positive pelvic lymph node,withdrew from the treatment and died 6 months later).Conclusion:Laparoscopic surgery for the treatment of gynecological malignancies is safe and feasible,and has satisfactory result,but the surgeon must have skilled operation technique and treatment experience of operation complication.