Hertel H, Possover M, Kühne-Heid R, Schneider A
Department of Gynecology, Friedrich Schiller University of Jena, Bachstrasse 18, D-07740 Jena, Germany.
Surg Endosc. 2001 Mar;15(3):324. doi: 10.1007/s004640042005. Epub 2001 Feb 6.
We present the case of a 39-year-old gravida I para 0 woman who underwent laparoscopic staging of lymph node involvement in cervical cancer in the 19th week of pregnancy. She had been diagnosed with adenosquamous carcinoma of the cervix, stage 1B1, grade 2, with tumor involvement of the lymphovascular space and tumor involved resection margins via a cone biopsy in the 16th week of pregnancy. In order to decide whether it would be safe to proceed with the pregnancy, she was submitted to the laparoscopic exposure and removal of 18 parametric and pelvic lymph nodes. One positive lymph node was detected at the right internal iliac artery; therefore, an open radical hysterectomy with paraaortic lymphadenectomy was performed. This case shows that lymph node staging for cervical cancer can be done laparoscopically in the 2nd trimester. Information yielded during the course of this procedure can be crucial in deciding whether it is possible to preserve the pregnancy.
我们报告一例39岁初产妇，孕19周时因宫颈癌行腹腔镜淋巴结分期手术。她在孕16周时经宫颈锥切活检被诊断为宫颈腺鳞癌，1B1期，2级，肿瘤侵犯淋巴管间隙且切缘有肿瘤累及。为决定继续妊娠是否安全，她接受了腹腔镜检查，暴露并切除18个宫旁及盆腔淋巴结。在右髂内动脉处发现1个阳性淋巴结；因此，行开放性根治性子宫切除术及腹主动脉旁淋巴结清扫术。该病例表明，孕中期可通过腹腔镜对宫颈癌进行淋巴结分期。该手术过程中获得的信息对于决定是否能够继续妊娠至关重要。
