论文部分内容阅读
目的腹腔镜用于妇科肿瘤适应证的研讨。方法腹腔镜下施行囊肿剥除或附件切除,子宫切除,妇科恶性肿瘤盆腔淋巴结清扫、卵巢动静脉高位结扎或大网膜切除,并以开腹手术作为对照。结果腹腔镜手术时间短、创口小,利于创口缝合与愈合,大大减少了并发症的发生。开腹手术则受手术的大小和患者体质胖瘦直接影响。腹腔镜对卵巢囊性肿瘤(<10cm)或子宫肿瘤(子宫<3个月妊娠)的患者,与开腹手术相比,手术过程及时间并没有明显区别。但是腹腔镜对于更大的子宫肿瘤或囊性肿瘤的手术,时间和难度明显增加。与开腹手术相比,开腹手术有显著优势。对于有盆腔脏器粘连的,处理方法二者并无差异。使用腹腔镜对妇科恶性肿瘤实施手术,则需要相应的手术器械和高水平的操作技巧,且效果与开腹手术并无太大差别。结论腹腔镜手术适合较小的子宫肿瘤或卵巢囊性肿瘤,对于子宫恶性肿瘤,需要清扫淋巴结或探查上腹部者,腹腔镜手术的临床效果与开腹手术相差无几,但因腹腔镜对腹壁创伤小、腹腔脏器干扰小,术后很快康复,显著优于开腹手术术后康复状况。
Purpose of laparoscopy for gynecological indications of cancer. Methods Laparoscopic cyst removal or attachment resection, hysterectomy, pelvic lymphadenectomy of gynecologic malignancies, high ligation of the ovarian artery and vein or omental resection were performed. Laparotomy was performed as a control. Laparoscopic surgery results in a short time, a small wound, which will help wound suture and healing, greatly reducing the incidence of complications. Open surgery is affected by the size of the surgery and the weight and weight of patients with a direct impact. Laparoscopic surgery in patients with ovarian cystic tumors (<10 cm) or uterine tumors (<3 months of uterine pregnancy) did not differ significantly from open surgery. But laparoscopy for larger uterine tumors or cystic tumors surgery, time and difficulty increased significantly. Compared with open surgery, open surgery has significant advantages. For pelvic adhesions, there is no difference between the two treatment methods. The use of laparoscopic surgery for gynecological malignancies requires a corresponding surgical instrument and a high level of operating skills that does not differ significantly from open surgery. Conclusions Laparoscopic surgery is suitable for smaller uterine tumors or ovarian cystic tumors. For uterine malignancies, lymph node dissection or exploration of the upper abdomen is required. Laparoscopic surgery has almost the same clinical effect as laparotomy but due to laparoscopic trauma to the abdominal wall Small, small abdominal organ interference, postoperative recovery quickly, significantly better than postoperative recovery of open surgery.