目的 探讨腹腔镜下子宫深静脉入路C型宫颈癌根治术治疗宫颈癌的疗效。方法 2021 年 1 月～2022 年12 月我院采用腹腔镜下子宫深静脉入路C型宫颈癌根治术+盆腔淋巴结清扫术±腹主动脉旁淋巴结切除术治疗 58 例宫颈癌。建立通道后，在阔韧带后叶定位输尿管，分离输尿管后暴露子宫动脉，沿子宫动静脉背侧分离结缔组织，逐渐暴露子宫深静脉。将包绕子宫深静脉周围的宫旁淋巴结切除，单独送病理检查。继续向膀胱方向追踪子宫深静脉，游离其属支，血管夹双重夹闭。结果 手术时间(307。2±54。1)min，出血量中位数50(20，100)ml，淋巴结清扫(26。3±6。9)枚，留置导尿管时间(20。6±4。7)d，拔除腹腔引流管时间(9。4±4。1)d，肛门排气时间(36。7±4。1)h，抗生素使用时间(9。2±4。2)d，住院时间(13。4±2。6)d。术后并发症发生率 3。4%(2/58)。术后病理分期升级率为 22。4%(13/58)。术后欧洲癌症研究治疗组织(European Organization of Research and Treatment of Cancer，EORTC)生活质量核心30 问卷(Quality of Life Questionnaire-Core 30，QLQ-C30)评分较术前显著升高[(78。6±10。7)分vs。(47。1±7。6)分，t =17。177，P =0。000]。58 例随访4～25 个月，(13。5±6。2)月，无复发。结论 腹腔镜下子宫深静脉入路C型宫颈癌根治术疗效确切、安全可靠。
Curative Effect of Laparoscopic C-type Radical Hysterectomy Through Deep Uterine Vein Approach for Cervical Cancer
Objective To investigate the efficacy of laparoscopic C-type radical hysterectomy through deep uterine vein approach for the treatment of cervical cancer.Methods From January 2021 to December 2022,58 cases of cervical cancer were treated with deep uterine vein approach laparoscopic C-type radical hysterectomy in our hospital.After establishing the operation channel,the ureter was identified in the posterior lobe of the broad ligament,and the uterine artery was exposed after separating the ureter.The connective tissue was separated along the dorsal side of the uterine artery to gradually expose the deep uterine vein.The parametrial lymph nodes surrounding the deep uterine vein were resected and sent to pathology alone.The deep uterine vein was continuously tracked towards the bladder,and its branches were freed.The deep uterine vein and its tributaries were double clipped by vascular clamp.Results The operation time was(307.2±54.1)min,the median bleeding volume was 50(20,100)ml,the lymph node dissection number was(26.3±6.9),the indwelling catheter time was(20.6±4.7)d,the time to removal of abdominal drainage tube was(9.4±4.1)d,the anal exhaust time was(36.7±4.1)h,the antibiotics use time was(9.2±4.2)d,and the hospital stay was(13.4±2.6)d.The postoperative complication rate was 3.4%(2/58),and the postoperative pathological staging upgrade rate was 22.4%(13/58).The postoperative European Organization of Research and Treatment of Cancer(EORTC)Quality of Life Questionnaire-Core 30(QLQ-C30)score was significantly higher than before surgery[(78.6±10.7)points vs.(47.1±7.6)points,t = 17.177,P = 0.000].All the 58 cases were followed up for 4-25 months(mean,13.5±6.2 months),with no recurrence.Conclusion Laparoscopic C-type radical hysterectomy through deep uterine vein approach is effective,safe,and reliable.
Deep uterine veinCervical cancerLaparoscopeC-type hysterectomy
NETL
NSTL
万方数据
维普
