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) ›› 2021, Vol. 14 ›› Issue (06) : 363 -364. doi: 10.3877/cma.j.issn.1674-6899.2021.06.009

临床技术

腹腔镜子宫深静脉入路宫颈癌根治术
张婷1, 秦珊珊1, 郁胜胜1, 于鹃鹏1, 宋禹辰1, 高迎春1,()   
  1. 1. 223300 淮安,南京医科大学附属淮安市第一人民医院妇科
  • 收稿日期:2021-10-20 出版日期:2021-12-30
  • 通信作者: 高迎春

A novel direct approach to the deep uterine vein in laparoscopic radical hysterectomy

Ting Zhang1, Shanshan Qin1, Shengsheng Yu1, Juanpeng Yu1, Yuchen Song1, Yingchun Gao1,()   

  1. 1. The Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University, Huaian 223300, China
  • Received:2021-10-20 Published:2021-12-30
  • Corresponding author: Yingchun Gao
引用本文:

张婷, 秦珊珊, 郁胜胜, 于鹃鹏, 宋禹辰, 高迎春. 腹腔镜子宫深静脉入路宫颈癌根治术[J/OL]. 中华腔镜外科杂志(电子版), 2021, 14(06): 363-364.

Ting Zhang, Shanshan Qin, Shengsheng Yu, Juanpeng Yu, Yuchen Song, Yingchun Gao. A novel direct approach to the deep uterine vein in laparoscopic radical hysterectomy[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2021, 14(06): 363-364.

患者取膀胱截石位,全身麻醉,建立二氧化碳人工气腹,采用常规腹腔镜宫颈癌根治术的穿刺点置入Trocar。进入腹腔后首先定位阔韧带后叶的输尿管位置,打开其表面腹膜,分离输尿管周围筋膜,向外上牵拉输尿管,逐步向盆底方向分离,可以显露子宫深静脉。继续向膀胱方向分离,可以显露膀胱上静脉,血管夹双重夹闭,在子宫深静脉回流入髂内静脉部位血管夹双重夹闭。在输尿管的外上方分离子宫动脉,在近髂内动脉处血管夹双重夹闭,如果需切除附件,则在子宫动脉夹闭后,分离卵巢动(静)脉,然后夹闭。所有夹闭血管暂时均不切断,作为后面手术的解剖标志。其余手术步骤同常规宫颈癌根治术。

The patient took the bladder lithotomy position and underwent general anesthesia. Then carbon dioxide artificial pneumoperitoneum was established. Trocar was placed at the puncture point of conventional laparoscopic radical cervical cancer. After entering the abdominal cavity, we identified the ureter on the posterior peritoneum, and the peritoneum was dissected just above the ureter. By continuously exploring the pelvic cavity along the ureter, especially through the opening of the space below the ureter in a cranial to caudal direction, we could easily identify. Continue to dissect the deep uterine vein towards the bladder, we exposed the deep bladder vein. Then we clamped the blood vessel at the part where the deep uterine vein flows back into the internal iliac vein. Next, we separated the uterine artery at the outer upper part of the ureter, and clamped the vessel. If you need to cut off the accessories, separate the ovarian arteriovenous after the uterine artery clamped, and then clamp it. All clamped vessels were not cut off temporarily and used as anatomical markers for subsequent surgery. The next steps were the same as routine radical hysterectomy for cervical cancer.

1
矢吹朗彦. 新式广泛全子宫切除术:保留神经广泛全子宫切除术的解剖和手术技巧[M].沈阳:辽宁科学技术出版社,2014.
2
Horie A, Abiko K, Baba T, et al. A novel direct approach to the deep uterine vein in laparoscopic radical hysterectomy[J]. Journal of Minimally Invasive Gynecology, 202128(8),1444-1445.
3
Zhao D, Li B, Zheng S, et al. Separate lateral parametrial lymph node dissection improves detection rate of parametrial lymph node metastasis in early-stage cervical cancer: 10-year clinical evaluation in a single center in China[J]. Chin J Cancer Res, 202032(6):804-814.
[1] 李国新, 陈新华. 全腹腔镜下全胃切除术食管空肠吻合的临床研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 1-4.
[2] 李子禹, 卢信星, 李双喜, 陕飞. 食管胃结合部腺癌腹腔镜手术重建方式的选择[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 5-8.
[3] 李乐平, 张荣华, 商亮. 腹腔镜食管胃结合部腺癌根治淋巴结清扫策略[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 9-12.
[4] 陈方鹏, 杨大伟, 金从稳. 腹腔镜近端胃癌切除术联合改良食管胃吻合术重建His角对术后反流性食管炎的效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 15-18.
[5] 许杰, 李亚俊, 韩军伟. 两种入路下腹腔镜根治性全胃切除术治疗超重胃癌的效果比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 19-22.
[6] 李刘庆, 陈小翔, 吕成余. 全腹腔镜与腹腔镜辅助远端胃癌根治术治疗进展期胃癌的近中期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 23-26.
[7] 任佳, 马胜辉, 王馨, 石秀霞, 蔡淑云. 腹腔镜全胃切除、间置空肠代胃术的临床观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 31-34.
[8] 赵丽霞, 王春霞, 陈一锋, 胡东平, 张维胜, 王涛, 张洪来. 内脏型肥胖对腹腔镜直肠癌根治术后早期并发症的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 35-39.
[9] 李博, 贾蓬勃, 李栋, 李小庆. ERCP与LCBDE治疗胆总管结石继发急性重症胆管炎的效果[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 60-63.
[10] 韩戟, 杨力, 陈玉. 腹部形态CT参数与完全腹腔镜全胃切除术术中失血量的关系研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 88-91.
[11] 王露, 周丽君. 全腹腔镜下远端胃大部切除不同吻合方式对胃癌患者胃功能恢复、并发症发生率的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 92-95.
[12] 冯旺, 马振中, 汤林花. CT扫描三维重建在肝内胆管细胞癌腹腔镜肝切除术中的临床研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 104-107.
[13] 王庆亮, 党兮, 师凯, 刘波. 腹腔镜联合胆道子镜经胆囊管胆总管探查取石术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 313-313.
[14] 杨建辉, 段文斌, 马忠志, 卿宇豪. 腹腔镜下脾部分切除术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 314-314.
[15] 叶劲松, 刘驳强, 柳胜君, 吴浩然. 腹腔镜肝Ⅶ+Ⅷ段背侧段切除[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 315-315.
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?