【摘要】 目的:探讨宫颈癌腹腔镜根治性子宫切除加盆腔淋巴结清扫术(TLRH+LPL)的并发症防治策略。方法:回顾性分析117例Ⅰb～Ⅱa宫颈癌LRH+LPL术中及术后并发症。结果:总中转开腹率1.71%(2/117),术中并发症发生率7.69%(9/117),其中髂血管损伤4例,除1例镜下处理髂总静脉的营养支失败中转开腹外,其余3例髂血管损伤均在镜下完成修补。术中膀胱损伤5例,除1例膀胱损伤中转开腹外,其余均在腹腔镜下完成。术后尿潴留38例,淋巴囊肿4例,输尿管瘘、肠梗阻、膀胱阴道瘘各1例。结论:随着腹腔镜技术的不断熟练和并发症防治技巧的掌握,宫颈癌腹腔镜根治性子宫切除加盆腔淋巴结清扫有望成为一种代替开腹手术极具潜力的手术方式。更多还原

【Abstract】 Objective:To explore the prevention and treatment of complications of cervical cancer after laparoscopic radical hysterectomy and pelvic lymphadenectomy (LRH+LPL).Methods:A retrospective study was conducted on 117 cases of cervical cancer undergoing LRH+LPL with International Federation of Gynecology and Obstetrics stage Ⅰb and Ⅱa.The intra-operative and post-operative complications rates were analyzed.Results:The overall conversion rate was 1.7% (2/117),the incidence of intra-operative complications was 7.69% (9/117).Four patients had vessel injuries,three of which were treated laparoscopically;one patient had a common iliac vein laceration that could not be treated laparoscopically after failing to deal with the injured branch of common iliac vein.Bladder injury occurred in five patients,one case converted to laparotomy and the others were treated laparoscopically.Post-operative complications included urinary retention (38 patients),lymphocyst (4 patients),ureteral fistulas (1 patient),bowel obstruction (1 patient),vesicovaginal fistula (1 patient).Conclusion:With the continuous skilled laparoscopic technology and the mastering of the tips of prevention and treatment of complications,LRH+LPL will be widely performed in the future.更多还原