摘要
目的描述新型"筷子法"单孔腹腔镜手术技术,探讨"筷子法"单孔腹腔镜广泛子宫切除及盆腔淋巴结清扫治疗宫颈癌的可行性、安全性及围手术期结局。方法 2016年10月至2017年10月,前瞻性纳入陆军军医大学第一附属医院妇产科诊断为宫颈癌患者,采用"筷子法"单孔腹腔镜技术,行单孔腹腔镜广泛子宫切除+盆腔淋巴结清扫术。对患者人口学特征和围手术期效果进行总结分析。结果 53例患者尝试手术,除1例因术中探查Ⅳ期子宫内膜异位症中转为多孔腹腔镜手术外,52例(98%)成功完成。52例均采用"筷子法"单孔腹腔镜技术,其中40例采用"单切口3通道"入路平台,12例为采用软性入路平台。中位手术时间212 min,平均术中出血量134 ml。2例术中血管损伤、1例膀胱损伤,均发生在最初的20例手术中,且均在术中单孔腹腔镜下完成修补。术后14 d发生输尿管阴道瘘1例,行输尿管膀胱再植术修补成功。结论采用"筷子法"单孔腹腔镜技术治疗宫颈癌是可行的,初步临床观察发现围手术期临床结局与文献报道的多孔腹腔镜手术类似,但在技术开展初期应重视预防术中并发症发生。
Objective To describe the new ＂chopsticks technique＂ single-site laparoscopic surgery technology, and to explore the feasibility, safety and pert operative outcome of laparoendoscopic single-site radical hysterectomy and pelvic lymphadeneetomy using ＂chopsticks technique＂. Methods From Oct. 2016 to Oct. 2017, Patients diagnosed with cervical cancer were prospectively enrolled in obstetrics and Gynecology Department of Southwest Hospital, Third Militat＂y Medical University. The demographic characteristics of the patients and the effect of perioperative period were summarized and analyzed. Results 53 cases were operated on, and 52 cases（98% ） were successfully completed ,and 1 cases were converted to 3- port laparoscopy due stage 1V endometriosis. All the 52 cases were used ＂chopsticks technique＂, of which 40 cases were used ＂single incision three channel＂ approach platform, and 12 cases were soft access platform. The median operation time was 212 min, and the average blood loss was 134 ml during the operation. 2 cases of vascular injury and 1 cases of bladder injury occurred in the first 20 cases, and all of them were repaired by single-site laparoscopy during the operation. 1 case of ureteral vaginal fistula occurred 14 days after the operation, and the ureterovesical reimplantation was successfully repaired. Conclusions The＂ chopsticks technique＂ single port laparoscopic surgery is feasible for the treatment of cervical cancer. Preliminary clinical observation shows that the perioperative clinical outcomes are similar to those reported by literature. However, in the initial stage of technology, we should pay attention to prevent intraoperative complications.
作者
王延洲
陈诚
徐嘉莉
李宇迪
邓黎
陈功立
梁志清
Wang Yanzhou, Chen Cheng, Xu Jiali, Li Yudi, Deng Li, Chen Gongli, Liang Zhiqing.(Department of Obstetrics and Gynecology, Southwest Hospital, Third Military Medical University, Chongqing 400038, Chin)
出处
《中华腔镜外科杂志（电子版）》
2018年第1期28-31,共4页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
基金
第三军医大学第一附属医院临床新技术原始创新型重点项目(SWH2016YSCXZD-07)
关键词
宫颈癌
单孔腹腔镜
广泛子宫切除
Cervical cancer
Laparoendoscopic single-site surgery
Radical hysterectomy
