早期子宫内膜癌的外科治疗

Surgical Treatment for Early Stage Endometrial Cancer

子宫内膜癌是最常见的妇科恶性肿瘤之一。最近的前瞻性研究表明,随着腹腔镜手术技术的进步,对子宫内膜癌患者进行微创手术治疗已经实现。标准的子宫内膜癌手术治疗为包括全子宫和双侧输卵管、卵巢在内的切除手术。最新发展的机器人手术平台为要求甚高的传统腹腔镜手术提供了可选的高级技术,并能使更多的子宫内膜癌患者采用微创手术进行治疗。早期子宫内膜癌的外科手术治疗中联合腹、盆腔淋巴结清扫的分期手术以及保留生育功能的治疗对患者的临床效果一直是热点话题。关于包括淋巴结清扫在内的全面分期手术对早期子宫内膜癌患者的益处仍存在争议。对目前早期子宫内膜癌的定义、预后因素及最新的手术治疗进展和一些正在被纳入的新技术进行综述。

Endometrial carcinoma is one of the most common gynecologic malignant tumor. Recent prospective data showed that, with the progress of laparoscopic operation techniques, minimally invasive surgery in patients with endometrial cancer treatment have been implemented. It is widely agreed that for early endometrial cancer standard operation treatment including operation excise uterus and bilateral tubal ovarian. Latest development of robotic surgical platform can offer optional advanced technologies for traditional laparoscopic surgery which demanding more, and can increase the number of patients with endometrial cancer treatment using minimally invasive surgery. The surgical treatment of early endometrial carcinoma combined abdominal and pelvic lymph node cleaning staging surgery as well as keep the reproductive function of patients with clinical effect has been a hot topic. The benefits of comprehensive staging operation, including lymph node cleaning in patients with early endometrial cancer is still controversial. This paper will review the current progress in the definition of early endometrial cancer, prognostic factors and new operation treatment and some are being incorporated into the new technology.