国际妇产科学杂志 ›› 2014, Vol. 41 ›› Issue (4): 333-338.

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微创技术在妇科恶性肿瘤中的应用

林少丹,林仲秋   

  1. 310000 广州,中山大学孙逸仙纪念医院妇瘤科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-08-15 发布日期:2014-08-15
  • 通讯作者: 林仲秋

Clinical Application of Minimally Invasive Techniques in Gynecological Malignant Tumor

LIN Shao-dan, LIN Zhong-qiu   

  1. Department of Gynecological Oncology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 310000, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-08-15 Online:2014-08-15
  • Contact: LIN Zhong-qiu

摘要: 微创手术技术,包括腹腔镜手术、机器人腹腔镜手术、宫腔镜手术、阴式手术和各种小切口的手术,具有创伤小、手术瘢痕小、术后恢复快、易被患者接受等特点,在妇科恶性肿瘤的诊治中发挥越来越重要的作用。三切口技术和腹腔镜下腹股沟淋巴结切除术有效地改善了外阴癌术后伤口愈合难的问题。经阴道或经腹腔镜下的全子宫切除术、腹腔镜下附件切除术、腹腔镜下根治性子宫切除术、腹腔镜下盆腔淋巴结切除术可以运用于适合的宫颈癌或子宫内膜癌患者。除了部分经选择的早期卵巢癌分期手术和孤立复发病灶的评估检查外,其他卵巢癌分期手术和细胞减灭术均应开腹进行,应严格掌握微创手术的适应证,选择最合适的个体化术式,达到最小的组织损伤、最小的炎症反应、最好的愈合和最理想的治疗效果。

关键词: 生殖器肿瘤, 女(雌)性, 阴道肿瘤, 宫颈肿瘤, 子宫内膜肿瘤, 卵巢肿瘤

Abstract: Minimally invasive operation technologies, including laparoscopic surgery, robot assisted laparoscopic surgery, hysteroscopic surgery, vaginal surgery, and all kinds of operation with small incision, with the advantage of fewer traumas, smaller scar , rapid recuperation and better acceptance by patients, play more and more important roles in the diagnosis and treatment of gynecologic malignant tumor. Three incision technique and laparoscopic inguinal lymphadenectomy are effective for improving postoperative poor wound healing in patients with vulva cancer. Transvaginal or laparoscopic hysterectomy, laparoscopic appendectomy, laparoscopic radical hysterectomy and pelvic lymphadenectomy are allowed to be performed in the suitable patients with cervical or endometrial cancer. For some select patients with early ovarian cancer and some with isolated recurrent lesion, minimally invasive surgical approaches may be employed by experienced gynecologic oncologists to achieve the surgical staging procedure or cytoreduction. In most instances with ovarian cancer, comprehensive surgical staging and tumor reductive surgery should be completed by an abdominal approach. The indications of minimally invasive operation should be strictly controlled. Highly individualized approach should be chosen to make sure the least injury, minimal inflammation, best healing and therapeutic effect.

Key words: Genital neoplasms, female, Vaginal neoplasms, Uterine cervical neoplasms, Endometrial neoplasms, Ovarian neoplasms