摘要
目的探讨腹腔镜下腹膜外盆腔淋巴结清扫术在妇科恶性肿瘤治疗中的可行性。方法 3例患者采用腹腔镜下经腹膜外进行盆腔淋巴结清扫术。第1例患者36岁,诊断高分化子宫内膜样腺癌Ⅰa期。第2例患者54岁,诊断宫颈中分化鳞癌Ⅱa期。第3例患者31岁,诊断中分化子宫内膜样腺癌Ⅰb期。手术采用水囊加CO2充气扩张法建立腹膜外间隙,分离切断圆韧带和子宫动脉。按由上到下,从外到内的原则,依次清扫双侧髂总、髂外、腹股沟、髂内及闭孔淋巴结。结果第1例术中穿透腹膜,行腹腔镜下腹膜内盆腔淋巴结清扫。后2例腹腔镜下腹膜外盆腔淋巴结清扫成功。手术时间分别为72和50min,出血量分别为200和100mL,清除盆腔淋巴结分别为31和14枚,均为阴性淋巴结。1例术后并发淋巴囊肿,经充分引流后淋巴囊肿消失。术后随访12～17个月,未见复发和转移。结论腹腔镜下腹膜外盆腔淋巴结清扫术在妇科恶性肿瘤治疗中的应用是可行的。为清除更多的淋巴结和避免淋巴囊肿等并发症的发生,需要进一步提高手术技巧。
[Objective] The aim of this study was to evaluate the feasibility of extraperitoneal laparoscopic lymphadenectomy for cervical and endometrial carcinoma.[Methods] Laparoscopic extraperitoneal lymph node dissection was performed in 3 patients.One patient affected by stage IIa cervical cancer and two patients affected by stage Ia-Ib endometrial carcinoma.The technique,extraperitoneal laparoscopic lymphadenectomy using a procedure of detachment of the extraperitoneal space with CO2 insufflation,was described.[Results] One patient had peritoneal tears causing CO2 gas leakage,and 2 patients successfully finished extraperitoneal laparoscopic pelvic lymphadenectomy.The operation time was 72 min and 50 min,and the estimated blood loss was 200 mL and 100 mL.The total number of resected nodes was 31 and 14,and no patients had lymph node metastasis.Lymphocyst was observed in one patient,no other intraoperative and postoperative complications occurred.[Conclusion] Extraperitoneal laparoscopic lymphadenectomy is a feasible procedure.
出处
《中国内镜杂志》
CSCD
北大核心
2012年第1期44-47,共4页
China Journal of Endoscopy
关键词
淋巴结清扫术
腹膜外
腹腔镜
lymph node dissection
extraperitoneal
laparoscopy
作者简介
[通信作者]孙霭萍，E—mail：changzangyan@163．com，电话：010—84206115
