国际妇产科学杂志 ›› 2018, Vol. 45 ›› Issue (4): 455-459.

• 综述 • 上一篇    下一篇

妇科恶性肿瘤腹腔镜术后穿刺孔转移的研究进展

戴春阳,韩璐   

  1. 116033  大连医科大学附属大连市妇产医院暨大连市妇幼保健院妇科
  • 收稿日期:2018-05-02 修回日期:2018-06-10 出版日期:2018-08-15 发布日期:2018-08-15
  • 通讯作者: 韩璐,E-mail:13940801858@163.com E-mail:13940801858@163.com
  • 基金资助:
    大连市科技计划项目(2014E14SF160)

Advances in the Study of Port Site Metastasis after Laparoscopic Surgery for Gynecologic Malignancies

DAI Chun-yang,HAN Lu   

  1. Department of Gynecology,Dalian Obstetrics and Gynecology Hospital Affiliated to of Dalian Medical University,Dalian City Maternity Hospital,Dalian 116033,Liaoning Province,China
  • Received:2018-05-02 Revised:2018-06-10 Published:2018-08-15 Online:2018-08-15
  • Contact: HAN Lu,E-mail:13940801858@163.com E-mail:13940801858@163.com
  • Supported by:
    Dalian Science and Technology Project

摘要: 腹腔镜术后腹部穿刺孔肿瘤种植或转移(port site metastasis,PSM)是腹腔镜手术后特有并发症;发病率与疾病的恶性程度、肿瘤种类、组织学类型、国际妇产科联盟(FIGO)分期、有无腹水、腹腔镜的目的等因素有关,妇科恶性肿瘤中卵巢癌的PSM发生率最高,晚期卵巢癌、大量腹水、恶性肿瘤破裂等与PSM发生密切相关;PSM发病与肿瘤生物学特性、外科手术技术、CO2及气腹、能量器械使用、宿主免疫反应等有关;选择合适病例、术中穿刺尽量减少组织损伤、严格遵守外科无瘤原则、术中避免CO2气体的泄露及骤然的释放、缩短气腹时间、术毕充分冲洗腹腔、器械及穿刺口,缝合5 mm以上的穿刺孔等是预防PSM发生的关键方法。

关键词: 生殖器肿瘤, 女(雌)性, 腹腔镜, 肿瘤转移

Abstract: Port site metastasis (PSM) is a special complication after laparoscopy. The incidence of the disease is associated with the malignancy of the disease, the types of tumors, the histologic type, the FIGO stage, the ascites and the purpose of laparoscopy. The highest incidence of PSM is the ovarian cancer in the gynecologic malignant tumor, and advanced cancer, massive ascites, and malignant tumor rupture are closely related to PSM. The occurrence of PSM is related to tumor biological characteristics, surgical techniques, CO2 and pneumoperitoneum, the use of energy instruments, host immune response, and so on. Selecting the appropriate cases, reducing tissue damage during the intraoperative biopsy, strictly obey the principle of surgical non-tumor, avoid the leakage or sudden release of CO2 gas during the operation, shorten the pneumoperitoneum time, flushing the abdominal cavity, the instruments and the port sites at the end of surgery, suturing puncture holes above 5 mm are the key methods to prevent the occurrence of PSM.

Key words: Genital neoplasms, female, Laparoscopes, Neoplasm metastasis

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