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目的:探讨宫颈癌腹腔镜根治性子宫切除加盆腔淋巴结清扫术(TLRH+LPL)的并发症防治策略。方法:回顾性分析117例Ⅰb～Ⅱa宫颈癌LRH+LPL术中及术后并发症。结果:总中转开腹率1.71%(2/117),术中并发症发生率7.69%(9/117),其中髂血管损伤4例,除1例镜下处理髂总静脉的营养支失败中转开腹外,其余3例髂血管损伤均在镜下完成修补。术中膀胱损伤5例,除1例膀胱损伤中转开腹外,其余均在腹腔镜下完成。术后尿潴留38例,淋巴囊肿4例,输尿管瘘、肠梗阻、膀胱阴道瘘各1例。结论:随着腹腔镜技术的不断熟练和并发症防治技巧的掌握,宫颈癌腹腔镜根治性子宫切除加盆腔淋巴结清扫有望成为一种代替开腹手术极具潜力的手术方式。
Objective: To investigate the prevention and treatment of complications of laparoscopic radical hysterectomy and pelvic lymphadenectomy (TLRH + LPL). Methods: Retrospective analysis of 117 cases of Ⅰb Ⅱ Ⅱ cervical cancer LRH LPL intraoperative and postoperative complications. Results: The total conversion to laparotomy was 1.71% (2/117). The incidence of intraoperative complications was 7.69% (9/117), including 4 cases of iliac vascular injury. Except for 1 cases, iliac vein veins were unsuccessfully managed Open, the remaining three cases of iliac vascular injury were repaired under the microscope. Intraoperative bladder injury in 5 cases, except for 1 case of bladder injury transferred to open surgery, the rest are done in laparoscopy. Postoperative urinary retention in 38 cases, 4 cases of lymphatic cyst, ureteral fistula, intestinal obstruction, vesicovaginal fistula in 1 case. Conclusion: With the continuous proficiency of laparoscopic techniques and mastery of complications prevention and treatment, laparoscopic radical hysterectomy and pelvic lymphadenectomy are expected to become a promising alternative surgical method for open surgery.