标题：腹腔镜妇科恶性肿瘤手术25例临床体会

      作者：万晨东，朱晨燕，徐云，郑丽萍，童元枝，李敏    宜兴市第四人民医院妇产科，江苏 宜兴 214200

      卷次： 2019年30卷10期

      【摘要】 目的 探讨开展腹腔镜下妇科恶性肿瘤手术的安全性、有效性和可行性。方法 回顾性分析 2013年 5月至 2018年 12月在宜兴市第四人民医院妇产科接受腹腔镜妇科恶性肿瘤手术的 25例患者的临床资料。结果 25例患者中接受腹腔镜宫颈癌根治术9例，腹腔镜子宫内膜癌分期手术10例，腹腔镜卵巢肿瘤分期手术5例，腹腔镜子宫肉瘤手术1例，无一例中转开腹。术后随访，1例宫颈鳞癌ⅡA1期，术后病理盆腔淋巴结6枚阳性，术后拒绝补充放化疗，失访，追踪得知患者一年后死亡。1例子宫内膜低分化腺癌ⅢC1期，盆腔淋巴结5枚阳性，术后补充放化疗，一年半肿瘤远处转移，现在后续治疗中。其余患者均未发现异常，继续随访中。结论 严格按照肿瘤规范，正确把握手术适应证，不断提高手术操作技能，掌握手术要点以及并发症防治技巧，开展腹腔镜下妇科恶性肿瘤手术是安全、可行的。
      【关键词】 腹腔镜；妇科恶性肿瘤；手术要点；并发症；防治；可行性
      【中图分类号】 R737.3 【文献标识码】 A 【文章编号】 1003—6350（2019）10—1322—04

Clinical experience of laparoscopic surgery for gynecologic malignancy in 25 cases.
WAN Chen-dong, ZHUChen-yan, XU Yun, ZHENG Li-ping, TONG Yuan-zhi, LI Min. Department of Obstetrics and Gynecology, Fourth People'sHospital of Yixing City, Yixing 214200, Jiangsu, CHINA
【Abstract】 Objective To explore the safety, effectiveness, and feasibility of laparoscopic surgery for gyneco-logic malignancy. Methods The clinical data of 25 patients with gynecological malignant tumors who underwent lapa-roscopic surgery in Fourth People's Hospital of Yixing from May 2013 to December 2018 were analyzed retrospectively.Results Of the 25 patients, 9 underwent laparoscopic radical resection of cervical cancer, 10 underwent laparoscopicstaging of endometrial cancer, 5 underwent laparoscopic staging of ovarian tumor, and 1 underwent laparoscopic surgeryfor uterine sarcoma. During the postoperative follow-up, 1 case of cervical squamous cell carcinoma in stageⅡA1 with6 positive pathological pelvic lymph nodes after surgery refused to receive radiotherapy and chemotherapy after surgeryand was lost to follow-up, who died one year later; 1 case of endometrial poorly differentiated adenocarcinoma in stageⅢC1 with 5 positive pelvic lymph nodes received radiotherapy and chemotherapy after surgery, and was found with dis-tant metastasis in one and a half years, which was now undergoing follow-up treatment. No abnormalities were found inthe remaining patients, and follow-up was continued. Conclusion It is safe and feasible to carry out laparoscopic sur-gery for gynecological malignant tumors by strictly following the tumor standard, correctly grasping the operation indica-tions, continuously improving the operation skills, mastering the key points of operation and the prevention and treat-ment of complications.
      【Key words】 Laparoscope; Gynecologic malignancy; Surgical points; Complications; Prevention and treatment;Feasibility·短篇论著·doi:10.3969/j.issn.1003-6350.2019.10.029