【摘要】 目的探讨腹腔镜下系统的淋巴结清扫术在Ⅰ期子宫内膜癌治疗中的应用价值以及手术的可行性。方法对我院收治的55例临床诊断为Ⅰ期的子宫内膜癌患者行腹腔镜下系统的腹主动脉旁及盆腔淋巴结清扫术,观察手术情况及并发症,并分析术后淋巴结转移情况。结果 1)55例患者均顺利完成手术,手术成功率100%,手术平均时间及出血量分别为(109.7±33.4)min与(62.4±26.8)mL,手术并发症少且轻,主要为术后盆腔感染及淋巴囊肿;2)55例患者中有5例(9.1%)出现淋巴结转移,包括盆腔淋巴结转移4例(7.3%),腹主动脉旁淋巴结转移2例(3.6%),其中1例(1.8%)同时出现盆腔及腹主动脉旁淋巴结转移,1例(1.8%)仅有腹主动脉旁淋巴结转移;3)淋巴结转移与组织学类型、组织学分级、深肌层浸润及脉管浸润密切相关(均P<0.05)。结论Ⅰ期子宫内膜癌仍存在腹膜后淋巴结转移风险,对其行腹腔镜下系统的淋巴结清扫可获得准确的手术病理分期,为后续治疗提供依据,该术式安全可行,临床上值得推广应用。更多还原

【Abstract】 Objective To investigate the application value of laparoscopic systematic lymphadenectomy in the treatment of stageⅠendometrial carcinoma and the feasibility in carrying out the surgery.Methods A total of 55 cases of patients with stageⅠendometrial carcinoma were underwent laparoscopic systematic para-aortic and pelvic lymphadenectomy,the surgical efficiency and complications were observed and the status of lymph node metastases was discussed at the same time.Results The success rate of operation was 100%,the mean operation time and blood loss was(109.7±33.4)min and(62.4±26.8)mL respectively,the complication of operation was quite low and mild and the major of which was pelvic infection and lymphocyst.Among 55 patients,5 patients(9.1%)had lymph node metastases:both pelvic and para-aortic in 1 patient(1.8%),only pelvic in 4 patients(7.3%),and exclusively isolated to the para-aortic in 1 patient(1.8%).Tumor histological type,histological grade,deep stromal invasion and vessel invasion were associated with lymph node metastases(P<0.05).Conclusion The results of our study suggest that patient with stageⅠendometrial carcinoma still has the risk of retroperitoneal lymph node metastasis.Accurate surgical pathologic staging and a guidance for postoperative adjuvant therapy can be achieved by laparoscopic lymphadenectomy.The operation is safe and feasible and which is worthy of popularizing in clinical treatment.更多还原