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目的评价经腹腔镜手术联合使用超声刀及Ligasure治疗子宫恶性肿瘤的临床疗效。方法选取子宫恶性肿瘤患者20例,根据病情行腹腔镜下根治性子宫切除加盆腔淋巴结清除术,术中联合使用超声刀及Ligasure。观察手术时间、术中出血量、宫旁组织及阴道切除范围、盆腔淋巴结清除数目及术后肛门排气时间、发热时间、尿管保留时间、术后并发症等临床指标。结果 20例患者腹腔镜手术全部成功,手术时间(209.5±40.5)min;术中出血(210.6±102.3)ml,切除淋巴结(19.2±6.7)枚;术后肛门排气时间(2.3±1.9)d,术后发热(4.1±2.1)d,尿管拔除时间(12.5±3.3)d。所有病例切除宫旁组织达到广泛切除要求,病理报告断端及阴道切缘均阴性。术后8d发生不全肠梗阻1例,经保守治疗好转;其余患者术后无并发症出现。结论腹腔镜手术中联合使用超声刀及Ligasure行根治性子宫切除加盆腔淋巴清除术治疗子宫恶性肿瘤具有可行性、安全有效。
Objective To evaluate the clinical efficacy of laparoscopic surgery combined with ultrasonic knife and Ligasure in the treatment of uterine malignancies. Methods Twenty patients with malignant uterine cancer were selected. According to the condition, radical hysterectomy and pelvic lymphadenectomy were performed. Ultrasound knife and Ligasure were used intraoperatively. Observe the operation time, intraoperative blood loss, uterine tissue and vaginal resection range, pelvic lymph node clearance and postoperative anal exhaust time, fever time, catheter retention time, postoperative complications and other clinical indicators. Results All the laparoscopic operations were successful in 20 patients (209.5 ± 40.5) min, intraoperative bleeding (210.6 ± 102.3) ml and excision of lymph nodes (19.2 ± 6.7). The time of postoperative anal exhaust was (2.3 ± 1.9) days , Postoperative fever (4.1 ± 2.1) d, catheter removal time (12.5 ± 3.3) d. Excision of uterine tissue in all cases to achieve a wide range of excision requirements, the pathology report of the ends and vaginal margins were negative. One case of incomplete bowel obstruction occurred 8 days after operation, which was improved by conservative treatment. No complications occurred in the rest of the patients. Conclusions Laparoscopic surgery with ultrasonic scalpel and Ligasure radical hysterectomy plus pelvic lymphadenectomy for the treatment of uterine malignancies is feasible, safe and effective.