切换至 "中华医学电子期刊资源库"

中华腔镜外科杂志(电子版) ›› 2018, Vol. 11 ›› Issue (01) : 28 -31. doi: 10.3877/cma.j.issn.1674-6899.2018.01.008

所属专题: 文献

论著

"筷子法"单孔腹腔镜技术在宫颈癌中的应用
王延洲1, 陈诚1, 徐嘉莉1, 李宇迪1, 邓黎1, 陈功立1, 梁志清1,()   
  1. 1. 400038 重庆,陆军军医大学第一附属医院妇产科
  • 收稿日期:2017-12-29 出版日期:2018-02-28
  • 通信作者: 梁志清
  • 基金资助:
    第三军医大学第一附属医院临床新技术原始创新型重点项目(SWH2016YSCXZD-07)

The application of "chopsticks technique" single-site laparoscopic surgery technology in cervical cancer

Yanzhou Wang1, Cheng Chen1, Jiali Xu1, Yudi Li1, Li Deng1, Gongli Chen1, Zhiqing Liang1,()   

  1. 1. Department of Obstetrics and Gynecology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
  • Received:2017-12-29 Published:2018-02-28
  • Corresponding author: Zhiqing Liang
  • About author:
    Corresponding author: Liang zhiqing, Email:
引用本文:

王延洲, 陈诚, 徐嘉莉, 李宇迪, 邓黎, 陈功立, 梁志清. "筷子法"单孔腹腔镜技术在宫颈癌中的应用[J/OL]. 中华腔镜外科杂志(电子版), 2018, 11(01): 28-31.

Yanzhou Wang, Cheng Chen, Jiali Xu, Yudi Li, Li Deng, Gongli Chen, Zhiqing Liang. The application of "chopsticks technique" single-site laparoscopic surgery technology in cervical cancer[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2018, 11(01): 28-31.

目的

描述新型"筷子法"单孔腹腔镜手术技术,探讨"筷子法"单孔腹腔镜广泛子宫切除及盆腔淋巴结清扫治疗宫颈癌的可行性、安全性及围手术期结局。

方法

2016年10月至2017年10月,前瞻性纳入陆军军医大学第一附属医院妇产科诊断为宫颈癌患者,采用"筷子法"单孔腹腔镜技术,行单孔腹腔镜广泛子宫切除+盆腔淋巴结清扫术。对患者人口学特征和围手术期效果进行总结分析。

结果

53例患者尝试手术,除1例因术中探查Ⅳ期子宫内膜异位症中转为多孔腹腔镜手术外,52例(98%)成功完成。52例均采用"筷子法"单孔腹腔镜技术,其中40例采用"单切口3通道"入路平台,12例为采用软性入路平台。中位手术时间212 min,平均术中出血量134 ml。2例术中血管损伤、1例膀胱损伤,均发生在最初的20例手术中,且均在术中单孔腹腔镜下完成修补。术后14 d发生输尿管阴道瘘1例,行输尿管膀胱再植术修补成功。

结论

采用"筷子法"单孔腹腔镜技术治疗宫颈癌是可行的,初步临床观察发现围手术期临床结局与文献报道的多孔腹腔镜手术类似,但在技术开展初期应重视预防术中并发症发生。

Objective

To describe the new "chopsticks technique" single-site laparoscopic surgery technology, and to explore the feasibility, safety and peri operative outcome of laparoendoscopic single-site radical hysterectomy and pelvic lymphadenectomy using "chopsticks technique" .

Methods

From Oct.2016 to Oct. 2017, Patients diagnosed with cervical cancer were prospectively enrolled in obstetrics and Gynecology Department of Southwest Hospital, Third Military Medical University. The demographic characteristics of the patients and the effect of perioperative period were summarized and analyzed.

Results

53 cases were operated on, and 52 cases(98%) were successfully completed , and 1 cases were converted to 3-port laparoscopy due stage Ⅳ endometriosis. All the 52 cases were used "chopsticks technique" , of which 40 cases were used "single incision three channel" approach platform, and 12 cases were soft access platform. The median operation time was 212 min, and the average blood loss was 134 ml during the operation. 2 cases of vascular injury and 1 cases of bladder injury occurred in the first 20 cases, and all of them were repaired by single-site laparoscopy during the operation. 1 case of ureteral vaginal fistula occurred 14 days after the operation, and the ureterovesical reimplantation was successfully repaired.

Conclusions

The "chopsticks technique" single port laparoscopic surgery is feasible for the treatment of cervical cancer. Preliminary clinical observation shows that the perioperative clinical outcomes are similar to those reported by literature. However, in the initial stage of technology, we should pay attention to prevent intraoperative complications.

[1]
Wang Y, Deng L, Xu H, et al. Laparoscopy versus laparotomy for the management of early stage cervical cancer[J]. Bmc Cancer, 2015, 15(1): 928-931.
王延洲,陈功立,徐嘉莉,等. 单孔腹腔镜广泛子宫切除盆腔淋巴结清扫治疗宫颈癌:一项单中心的初步研究[J]. 第三军医大学学报,2017, 39(13):1392-1395.
[3]
孙大为,张俊吉,熊巍,等. 单孔腹腔镜下子宫内膜癌分期手术的临床报告[J/CD]. 中华腔镜外科杂志(电子版), 2014,7(1):10-13.
[4]
孙大为,张颖. 单孔腹腔镜手术在异位妊娠诊治中的应用[J]. 中国实用妇科与产科杂志,2017, 33(9):903-906.
[5]
Ishikawa N, Arano Y, Shimizu S, et al. Single incision laparoscopic surgery (SILS) using cross hand technique[J]. Minim Invasive Ther Allied Technol, 2009, 18(6): 322-324.
[6]
Garrett LA. Laparoendoscopic single-site radical hysterectomy: the first report of LESS type Ⅲ hysterectomy involves a woman with cervical cancer[J]. American Journal of Obstetrics & Gynecology, 2012, 207(6): 1-2.
[7]
Boruta DM, Fagotti A, Bradford LS, et al. Laparoendoscopic single-site radical hysterectomy with pelvic lymphadenectomy: initial multi-institutional experience for treatment of invasive cervical cancer[J]. Journal of Minimally Invasive Gynecology, 2014, 21(3): 394-398.
[8]
Figurelli J, Bresson L, Narducci F, et al. Single-port access laparoscopic surgery in gynecologic oncology: outcomes and feasibility[J]. International Journal of Gynecological Cancer Official Journal of the International Gynecological Cancer Society, 2014, 24(6): 1126-1132.
[9]
Bedaiwy MA, Sheyn D, Eghdami L, et al. Laparoendoscopic single-site surgery for benign ovarian cystectomies[J]. Gynecologic & Obstetric Investigation, 2015, 79(3): 179-183.
[10]
Park JY, Kim DY, Kim SH, et al. Laparoendoscopic single-site compared with conventional laparoscopic ovarian cystectomy for ovarian endometrioma[J]. Journal of Minimally Invasive Gynecology, 2015, 22(5): 813-819.
[11]
Lee J, Kim S, Nam EJ, et al. Single-port access versus conventional multi-port access total laparoscopic hysterectomy for very large uterus[J]. 2015, 58(3): 239-245.
[12]
Park JY, Nho J, Cho IJ, et al. Laparoendoscopic single-site versus conventional laparoscopic-assisted vaginal hysterectomy for benign or pre-invasive uterine disease[J]. Surgical Endoscopy & Other Interventional Techniques, 2015, 29(4): 890-897.
[13]
Fagotti A, Bottoni C, Vizzielli G, et al. Laparoendoscopic single-site surgery (LESS) for treatment of benign adnexal disease: single-center experience over 3-years[J]. J Minim Invasive Gynecol, 2012, 19(6): 695-700.
[14]
AbuRustum NR, Gemignani ML, Moore K, et al. Total laparoscopic radical hysterectomy with pelvic lymphadenectomy using the argon-beam coagulator: pilot data and comparison to laparotomy[J]. Gynecologic Oncology, 2003, 91(2): 402-409.
[15]
梁志清,徐惠成,熊光武,等. 腹腔镜在子宫颈癌治疗中的应用:附37例分析[J]. 中国微创外科杂志,2002, 2(1):62-63.
[1] 母德安, 李凯, 张志远, 张伟. 超微创器械辅助单孔腹腔镜下脾部分切除术[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 14-14.
[2] 庄宝雄, 邓海军. 单孔+1腹腔镜直肠癌侧方淋巴结清扫术[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 601-601.
[3] 李凯, 张志远, 苏怀东, 向涵, 张伟. 一种可拆卸组装的腹腔镜手术器械在单孔腹腔镜阑尾切除术中的临床应用[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(03): 250-250.
[4] 夏慧, 廖慧, 戴艳萍, 吴俊萍, 杨诚, 李建雄, 刘存东. 医护合作——快速康复模式在单孔腹腔镜上尿路重建围手术期的应用研究[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(03): 266-270.
[5] 胡启明, 鄢潇, 尤志学, 黄骁昊. 经瘢痕处单孔腹腔镜下切除多病灶腹壁子宫内膜异位症[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(05): 314-317.
[6] 徐敬云, 丁波, 蒋宇慧, 沈杨. 妊娠期单孔腹腔镜手术实施行与思[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(05): 262-266.
[7] 蒋露, 郑莹, 杨帆, 王乔, 王娜, 阳川华, 陈宇, 苟嘉妮, 邓露丝, 杨旭. 经脐单孔腹腔镜联合上腹部开腹行晚期卵巢癌肿瘤细胞减灭术[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(03): 177-181.
[8] 刘洪云, 李翠, 张海堂, 张玉英, 黄成香. 经脐单孔腹腔镜技术在子宫内膜癌手术中的应用[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(03): 182-184.
[9] 王酉, 严斌, 狄文, 楼微华. 经脐单孔腹腔镜前哨淋巴结活检术在早期子宫内膜癌手术中的探讨[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(03): 173-176.
[10] 曾纪晓, 梁子建. 单孔腹腔镜手术在儿童普通外科中的应用与展望[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(02): 65-69.
[11] 张可欣, 孙大为, 任常. 国产单孔蛇形臂腹腔镜机器人在妇科领域的应用探索[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(02): 106-110.
[12] 张秩坤, 李中策, 郑奕菲, 戚士芹. 经脐单孔腹腔镜脾部分切除在儿童脾病中的应用体会[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(02): 116-119.
[13] 徐晓钢, 曾纪晓, 刘斐, 兰梦龙, 陶波圆, 梁子建, 温俐妮, 叶志华. 单孔腹腔镜手术治疗Currarino综合征[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(02): 120-124.
[14] 李凯, 陈淋, 苏怀东, 向涵, 张伟. 超微创器械在改良单孔腹腔镜巨大肝囊肿开窗引流及胆囊切除中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 144-144.
[15] 李超迪, 刘娟芳, 闫肃, 秦胜东, 张镐哲, 常琼方, 韩新巍, 张建好. 血管性介入治疗在宫颈癌大出血患者中的临床疗效[J/OL]. 中华介入放射学电子杂志, 2024, 12(03): 217-220.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?