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目的探讨子宫恶性肿瘤腹腔镜手术治疗的可行性与实用价值。方法对2000年8月至2005年1月间沈阳市妇婴医院26例子宫颈癌和6例子宫内膜癌行腹腔镜下广泛或次广泛子宫切除及盆腔淋巴结清扫术,对33例子宫内膜癌行筋膜外子宫全切、双附件切除及盆腔淋巴结清扫术,对7例Ⅰb1期前子宫颈癌患者行腹腔镜下盆腔淋巴结清扫术及宫颈根治术。分析其手术时间、术中出血量、淋巴结清除数目、术后恢复情况。结果腹腔镜下广泛(或)次广泛子宫切除术及盆腔淋巴结清扫术的平均手术时间(261±62)min,平均出血量(357±46)mL,平均清除淋巴结(21.7±4.5)个。术后尿潴留9例。结论子宫恶性肿瘤的腹腔镜手术因其独具优势而有发展前景,手术成功的关键在于适应证的正确选择及操作技术的熟练。
Objective To investigate the feasibility and practical value of laparoscopic surgery for malignant uterine cancer. Methods Between August 2000 and January 2005, 26 cases of cervical cancer and 6 cases of endometrial cancer in Shenyang Maternity and Infant Hospital were treated by laparoscopic extensive or subtotal hysterectomy and pelvic lymphadenectomy. 33 cases of endometrial Extracapsular uterine cancer resection, double attachment resection and pelvic lymph node dissection, 7 cases of pre-stage Ⅰ 1b cervical cancer patients underwent laparoscopic pelvic lymph node dissection and radical mastectomy. Analysis of the operation time, blood loss, lymph node clearance, postoperative recovery. Results The average operation time (261 ± 62) min, average bleeding amount (357 ± 46) mL and average clearance lymph node (21.7 ± 4.5) of laparoscopic radical hysterectomy and pelvic lymphadenectomy were significantly lower than those of the control group. Postoperative urinary retention in 9 cases. Conclusions Laparoscopic surgery of uterine malignant tumors has its own prospective prospects because of its unique advantages. The key to successful operation lies in the correct choice of indications and the proficiency of operation techniques.