精准-间隙解剖技术在腹腔镜广泛性子宫切除术＋腹腔镜下盆腔淋巴结切除术中预防并发症的临床价值

Clinical value of precise-fascia space dissection technique in prevention of complications in laparoscopic radical hysterectomy combined with laparoscopic pelvic lymphadenectomy

目的 探讨精准-间隙解剖技术在腹腔镜广泛性子宫切除术（LRH）＋腹腔镜下盆腔淋巴结切除术（LPL）中预防并发症的临床价值.方法 回顾性分析采用精准-间隙解剖技术施行LRH＋ LPL治疗的30例早期子宫恶性肿瘤患者的临床资料.结果 30例患者全部成功施行LRH＋ LPL,手术时间（253.2±30.5） min,术中出血量（180.3±83.2） ml,切除盆腔淋巴结（13.2士4.0）枚,术后肠功能恢复时间（2.5±0.9）d,术后留置尿管时间（13±5）d;术后发生淋巴漏3例,经禁食和静脉营养治疗痊愈;无输尿管、膀胱及大血管损伤.30例术后随访6 ～ 72个月,未发现复发患者.结论 采用精准-间隙解剖技术施行LRH＋ LPL,按层次解剖、间隙分离,可避免输尿管、膀胱及大血管损伤等严重并发症.

Objective To research the clinical value of precise-fascia space dissection technique in laparoscopic radical hysterectomy （LRH） combined with laparoscopic pelvic lymphadenectomy （LPL）.Methods A retrospective analysis for 30 cases with early uterine malignancy operated by LRH ＋ LPL were conducted,each patient was used for precise-fascia space dissection technique.Results All cases were successfully performed LRH ＋ LPL under laparoscopy.The operative time was （253.2 ± 30.5） min,the blood loss in operation was （180.3 ± 83.2） ml,the amount of the excised lymph nodes was （13.2 ± 4.0） pieces,the time of gastrointestinal tract functional rehabilitation was （2.5 ± 0.9） d,the time of keeping urinary catheter was （13 ± 5） d.Three cases occurred lymphatic leakage and recovered after fasting and intravenous nutrition.None occurred ureter,bladder and vascular injury.Followed up for 6-72 months,none occurred recurrence or death.Conclusion LRH ＋ LPL using precise-fascia space dissection technique can avoid ureter,bladder and vascular injury.