内镜在子宫内膜癌诊治中的应用

Diagnosis and treatment of endometrial cancer by endoscopy

宫腔镜下子宫内膜活检提高了子宫内膜癌诊断的准确率,可能导致癌细胞的逆行性扩散,但对预后无明显影响。宫腔镜下癌灶切除术联合孕激素治疗为有生育要求的早期患者带来新的治疗方法。腹腔镜下全面分期手术应用于早期子宫内膜癌的治疗是安全可行的,且具有术中出血及术后疼痛少,住院时间短,恢复快,术后感染、盆腹腔粘连及淋巴囊肿形成少,生活质量高等优点,对患者预后无不良影响。术中举宫器的使用尚有争议。

Biopsy performed by hysteroscopy was highly accurate in diagnosing endometrial cancer. Hysteroscopy did not adversely influence the prognosis of endometrial cancer although it may result in retrograde dissemination of cancer cells,. Combination of hysteroscopie resection and progesterone may represent a novel therapeutic option for those women with stage IA endometrial cancer who wish to preserve their fertility ability. Laparoscopie staging of endometrial cancer was feasible and safe, with ad- vantages of less hemorrhage and postoperative pain, shorter hospitalization, earlier recovery, less postoperative infection, adhesions and lymphocyst formation, improved quality of life, and it did not worsen the prognosis of patients. Cancer cell dissemination caused by the uterine manipulator during laparoscopic hysterectomy is still an issue of concern.