腹腔镜免举宫子宫内膜癌全面分期手术效果分析(附52例报告)

Analysis of laparoscopic comprehensive staging surgery without uterine manipulator for endometrial cancer:with a report of 52 cases

目的:探讨免举宫方式行腹腔镜子宫内膜癌全面分期手术的可行性及手术效果。方法:回顾分析2019年1月至2021年12月行腹腔镜免举宫子宫内膜癌全面分期手术的52例子宫内膜癌患者的临床资料,术中通过阴道内放置纱布、缝合牵拉子宫免用举宫器、淋巴结切除后立即装袋扎口、行阴道壁切开前镜下环扎封闭阴道穹隆以保证手术无瘤原则的实施。结果:52例手术均顺利完成无瘤操作,无中转开腹及脏器损伤。手术时间平均(327.4±68.1)min,出血量平均(97.5±65.4)mL,盆腔淋巴结清扫数量(25.65±8.6)枚,术后排气时间平均(1.60±0.53)d,术后拔除尿管时间为1(1,2)d。结论:应用免举宫方式行腹腔镜子宫内膜癌全面分期手术安全、可行,既能保证手术的无瘤性,也能体现微创手术快速康复的优势。

Objective:To discuss the feasibility and efficacy of laparoscopic comprehensive staging surgery without uterine manipulator for endometrial cancer.Methods:Clinical data of 52 patients with endometrial cancer underwent laparoscopic comprehensive staging surgery from Jan.2019 to Dec.2021 were analyzed retrospectively.During the operation,gauzes were placed in the vagina,the uterus was pulled by sutures without uterine manipulator,lymph nodes resected were bagged and ligatured immediately,and vaginal vault was closed by cerclage before incision of vaginal wall to minimize tumor spillage.Results:All 52 patients with endometrial cancer completed the laparoscopic comprehensive staging surgery safely and successfully.There was no conversion to laparotomy or organ injury during the operation.The average operation time was(327.4±68.1)min,the average blood loss was(97.5±65.4)mL,the mean pelvic lymph node dissected was(25.65±8.6),the postoperative exhaust time was(1.60±0.53)d,and the postoperative time of urinary catheter removal was 1(1,2)d.Conclusions:Laparoscopic comprehensive staging surgery without uterine manipulator is safe and feasible for endometrial cancer.It can not only ensure the non-tumor operation,but also incarnate advantage of rapid recovery from minimally invasive surgery.