CAJ | 학술논문

目的探讨精准-间隙解剖技术在腹腔镜广泛性子宫切除术(LRH)+腹腔镜下盆腔淋巴结切除术(LPL)中预防并发症的临床价值.方法回顾性分析采用精准-间隙解剖技术施行LRH+ LPL治疗的30例早期子宫恶性肿瘤患者的临床资料.结果 30例患者全部成功施行LRH+ LPL,手术时间(253.2±30.5) min,术中出血量(180.3±83.2) ml,切除盆腔淋巴结(13.2士4.0)枚,术后肠功能恢复时间(2.5±0.9)d,术后留置尿管时间(13±5)d;术后发生淋巴漏3例,经禁食和静脉营养治疗痊愈;无输尿管、膀胱及大血管损伤.30例术后随访6 ～ 72个月,未发现复发患者.结论采用精准-间隙解剖技术施行LRH+ LPL,按层次解剖、间隙分离,可避免输尿管、膀胱及大血管损伤等严重并发症.
목적 탐토정준-간극해부기술재복강경엄범성자궁절제술(LRH)+복강경하분강림파결절제술(LPL)중예방병발증적림상개치.방법 회고성분석채용정준-간극해부기술시행LRH+ LPL치료적30례조기자궁악성종류환자적림상자료.결과 30례환자전부성공시행LRH+ LPL,수술시간(253.2±30.5) min,술중출혈량(180.3±83.2) ml,절제분강림파결(13.2사4.0)매,술후장공능회복시간(2.5±0.9)d,술후류치뇨관시간(13±5)d;술후발생림파루3례,경금식화정맥영양치료전유;무수뇨관、방광급대혈관손상.30례술후수방6 ～ 72개월,미발현복발환자.결론 채용정준-간극해부기술시행LRH+ LPL,안층차해부、간극분리,가피면수뇨관、방광급대혈관손상등엄중병발증.
Objective To research the clinical value of precise-fascia space dissection technique in laparoscopic radical hysterectomy (LRH) combined with laparoscopic pelvic lymphadenectomy (LPL).Methods A retrospective analysis for 30 cases with early uterine malignancy operated by LRH + LPL were conducted,each patient was used for precise-fascia space dissection technique.Results All cases were successfully performed LRH + LPL under laparoscopy.The operative time was (253.2 ± 30.5) min,the blood loss in operation was (180.3 ± 83.2) ml,the amount of the excised lymph nodes was (13.2 ± 4.0) pieces,the time of gastrointestinal tract functional rehabilitation was (2.5 ± 0.9) d,the time of keeping urinary catheter was (13 ± 5) d.Three cases occurred lymphatic leakage and recovered after fasting and intravenous nutrition.None occurred ureter,bladder and vascular injury.Followed up for 6-72 months,none occurred recurrence or death.Conclusion LRH + LPL using precise-fascia space dissection technique can avoid ureter,bladder and vascular injury.