中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2009年
10期
10-11
,共2页
施晓燕%李芝芳%施晓莺%唐佳音
施曉燕%李芝芳%施曉鶯%唐佳音
시효연%리지방%시효앵%당가음
子宫颈癌%子宫内膜癌%根治术%盆腔淋巴结清扫术%腹膜外
子宮頸癌%子宮內膜癌%根治術%盆腔淋巴結清掃術%腹膜外
자궁경암%자궁내막암%근치술%분강림파결청소술%복막외
Cervical carcinoma%Endometrial Carcinoma%Radical surgery operation%Pelvic lymphadenectomy%Extraperitoneal
目的 探讨在妇科恶性肿瘤根治性手术中采用腹膜外盆腔淋巴结清扫术的优势.方法 在浸润性宫颈癌及子宫内膜癌的根治性手术中,选择47例行腹膜外盆腔淋巴结清扫术,并对该术式的操作方法及其优势作了详细的阐述.结果 除术中右髂总静脉及左闭孔静脉损伤各1例外,其余患者手术操作顺利.术中无恶心呕吐等胃肠道反应及心血管并发症,与腹膜内清扫术相比节省时间30 min;术后并发淋巴囊肿11例,腹壁切口淋巴漏1例,均经相应治疗后痊愈.结论 在宫颈癌及子宫内膜癌的根治性手术中采用腹膜外盆腔淋巴结清扫术,具有术野显露良好,无需腹壁自动牵开器,对盆腹腔干扰时间晚而短,避免因探查等操作而引起的恶心呕吐、血压下降等不良反应及减少术后肠粘连肠梗阻并发症等优点,而且坚持了"包抄歼癌"的手术原则,缩短了手术操作时间.
目的 探討在婦科噁性腫瘤根治性手術中採用腹膜外盆腔淋巴結清掃術的優勢.方法 在浸潤性宮頸癌及子宮內膜癌的根治性手術中,選擇47例行腹膜外盆腔淋巴結清掃術,併對該術式的操作方法及其優勢作瞭詳細的闡述.結果 除術中右髂總靜脈及左閉孔靜脈損傷各1例外,其餘患者手術操作順利.術中無噁心嘔吐等胃腸道反應及心血管併髮癥,與腹膜內清掃術相比節省時間30 min;術後併髮淋巴囊腫11例,腹壁切口淋巴漏1例,均經相應治療後痊愈.結論 在宮頸癌及子宮內膜癌的根治性手術中採用腹膜外盆腔淋巴結清掃術,具有術野顯露良好,無需腹壁自動牽開器,對盆腹腔榦擾時間晚而短,避免因探查等操作而引起的噁心嘔吐、血壓下降等不良反應及減少術後腸粘連腸梗阻併髮癥等優點,而且堅持瞭"包抄殲癌"的手術原則,縮短瞭手術操作時間.
목적 탐토재부과악성종류근치성수술중채용복막외분강림파결청소술적우세.방법 재침윤성궁경암급자궁내막암적근치성수술중,선택47례행복막외분강림파결청소술,병대해술식적조작방법급기우세작료상세적천술.결과 제술중우가총정맥급좌폐공정맥손상각1예외,기여환자수술조작순리.술중무악심구토등위장도반응급심혈관병발증,여복막내청소술상비절성시간30 min;술후병발림파낭종11례,복벽절구림파루1례,균경상응치료후전유.결론 재궁경암급자궁내막암적근치성수술중채용복막외분강림파결청소술,구유술야현로량호,무수복벽자동견개기,대분복강간우시간만이단,피면인탐사등조작이인기적악심구토、혈압하강등불량반응급감소술후장점련장경조병발증등우점,이차견지료"포초섬암"적수술원칙,축단료수술조작시간.
Objective To investigate advantages of extraperitoneal pelvic lymphadenectomy adopted in radical surgery operation of gynecological malignancy.Methods In radical surgery operations of invasive cervical carcinoma and endometrial carcinoma,47 cases were choosed to be done with extraperitoneal pelvic lymphadenectomy,the method of the operation and its advantages are also elaborated in detail.Results In addition to the results of the right common iliac vein and left obturator vein injury each exception,and the remaining patients were operated smoothly,with none of gastrointestinal reactions such as nausea and vomiting,and other cardiovascular complications.The operational time shortened 30 minutes compared with innerperitoneal lymphadenectomy.11 cases with lymphatic cyst and 1 case with abdominal incision lymphatic leak occurred after operation have been recovered after corresponding treatment.Conclusion The adoption of extraperitoneal pelvic lymphadenectomy in radical surgery operation of cervical cancer and endometrial cancer has the advantages of a good exposure of operational field,no need of the abdominal wall automatic retractor,a late and short abdominal interfere,the avoidance of adverse effects such as nausea,vomiting,blood pressure decreasing caused by operational exploratory and reduction of complications such as intestinal obstruction and intestine adhesion during and after operation,and adhere to the "F-outflanking cancer,"the operative principle,shorten the operation time.
