腹腔镜辅助阴式子宫切除术后子宫内膜癌阴道残端复发
Vaginal cuff recurrence of endometrial cancer treated by laparoscopic-assisted vaginal hysterectomy.
作者信息
Chu Christina S, Randall Thomas C, Bandera Christina A, Rubin Stephen C
机构信息
Division of Gynecologic Oncology, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
出版信息
Gynecol Oncol. 2003 Jan;88(1):62-5. doi: 10.1006/gyno.2002.6852.
BACKGROUND
Laparoscopic-assisted vaginal hysterectomy (LAVH) has been suggested as an alternative to total abdominal hysterectomy (TAH) for the treatment of early endometrial cancer. Although studies have reported good results with equivalent rates of recurrence and survival, the need for use of intrauterine manipulators during the LAVH raises the concern for operative dissemination of tumor cells.
CASES
We report three patients with stage I, noninvasive or superficially invasive endometrial cancer with vaginal cuff recurrence within 9 months of treatment by LAVH.
CONCLUSION
While LAVH may be a technically acceptable alternative to TAH for the management of early-stage endometrial cancer, its routine use should be undertaken with caution, as the long-term risks for recurrence and survival have yet to be defined in a randomized, controlled fashion.
背景
对于早期子宫内膜癌的治疗，腹腔镜辅助阴式子宫切除术（LAVH）已被提议作为全腹子宫切除术（TAH）的替代方法。尽管研究报告了其在复发率和生存率方面的等效良好结果，但LAVH术中需要使用子宫内操纵器引发了对肿瘤细胞手术播散的担忧。
病例
我们报告了3例I期非侵袭性或浅表侵袭性子宫内膜癌患者，在接受LAVH治疗后9个月内出现阴道残端复发。
结论
虽然对于早期子宫内膜癌的治疗，LAVH在技术上可能是TAH可接受的替代方法，但应谨慎进行常规使用，因为复发和生存的长期风险尚未通过随机对照方式确定。
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