国际妇产科学杂志

国际妇产科学杂志 ›› 2016, Vol. 43 ›› Issue (3): 343-347.

• 论著 • 上一篇    下一篇

腹腔镜下腹膜外淋巴结切除术在局部晚期宫颈癌中的初步临床研究

蒋叠，姚德生，卢艳，李菲，潘忠勉   

  1. 530021 南宁，广西医科大学附属肿瘤医院妇瘤科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2016-06-22 发布日期:2016-06-22
  • 通讯作者: 姚德生

Preliminary Clinical Study of Laparoscopic Retroperitoneal Lymph Node Dissection in Patients with Locally Advanced Cervical Cancer

JIANG Die, YAO De-sheng, LU Yan, LI Fei, PAN Zhong-mian   

  1. Department of Gynecological Oncology, Tumor Hospital Affiliated to Guangxi Medical University, Nanning 530021, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2016-06-22 Online:2016-06-22
  • Contact: YAO De-sheng

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摘要： 目的：探讨腹腔镜下腹膜外淋巴结切除术（laparoscopic retroperitoneal lymph node dissection，LRLD）在局部晚期宫颈癌（locally advanced cervical cancer，LACC）患者中应用的可行性和价值。方法：选取广西医科大学附属肿瘤医院病理学确诊及初诊宫颈癌且依据国际妇产科联盟（FIGO）2009年分期为ⅡB～ⅣA期的患者41例，按照手术方式分为腹膜外组（n=21）和经腹腔组（n=20），分别行腹腔镜下经腹腔及腹膜外腹主动脉旁淋巴结+盆腔淋巴结切除术。结果：腹膜外组（1例建立气腹过程失败）和经腹腔组手术顺利，其中腹膜外组手术时间（199.94±12.37） min、胃肠道恢复时间（13.54±2.35） h、术后拔尿管时间（6.42±0.74） h、手术距离放疗时间（10.50±2.90） d，均较经腹腔组缩短，且术中出血量（55.20±10.52） mL少于经腹腔组，差异有统计学意义（均P＜0.05）。结论：LRLD较经腹腔淋巴结切除术在LACC中的应用更具优势，弥补了影像学检查宫颈癌淋巴结转移的漏诊及假阳性等不足。

关键词: 宫颈肿瘤, 癌, 腹腔镜, 腹腔镜检查, 淋巴结切除术

Abstract: Objective: To investigate the feasibility and application of laparoscopic retroperitoneal lymph node dissection（LRLD） in locally advanced cervical cancer （LACC）. Methods: 41 cases in Tumor Hospital Affiliated to Guangxi Medical University diagnosed by pathology and FIGO 2009 staging of cervical cancer patients with stage ⅡB ~ ⅥA were divided into the LRLD group（n=21） and the abdominal cavity group（n=20），we performed laparoscopic abdominal aorta by abdominal cavity and peritoneal lymph nodes+pelvic lymph adenectomy. Results: 21 cases LRLD group （1 case failed to establish pneumoperitoneum process），the abdominal cavity group 20 cases were operated smoothly，including extraperitoneal group with the mean operation time（199.94±12.37） min，mean recovery time of gastrointestinal（13.54±2.35） h and urine tube（6.42 ±0.74） h function，and the time between surgery and radiotherapy（10.50 ±2.90） d，mean blood loss（55.20±10.52） mL，has statistically significantly lower than abdominal cavity group （all P＜0.05）. Conclusions: LRLD has more advantages in the application of LACC than abdominal cavity, compensate for the insufficient of imaging examination in diagnosis of cervical lymph node metastases.

Key words: Uterine cervical neoplasms, Carcinoma, Laparoscopes, Laparoscopy, Lymph node excision