Skret Andrzej, Obrzut Bogdan, Kluz Tomasz, Magoń Tomasz
Oddziału Ginekologii i Połoznictwa Wojewódzkiego Szpitala Specjalistycznego, Rzeszowie.
Ginekol Pol. 2003 May;74(5):377-83.
Radical vaginal hysterectomy has been performed in surgical treatment of cervical cancer for over one hundred years. After the term of decrease of popularity of this operation, nowadays we can observe gradual come back to the idea of radical vaginal hysterectomy. Possibility of association of advanced laparoscopic techniques/lymphadenectomy/with vaginal operation have changed the approach to the surgical treatment of cervical cancer. The aim of the study is to present the method of laparoscopic-vaginal radical hysterectomy based on Schauta-Amreich technique. The 51 year old women was admitted to the hospital and cervical cancer FIGO stage IIA was diagnosed according to clinical and histopathological examination. We performed laparoscopic-vaginal radical hysterectomy in general anaesthesia. First after cutting of ligamentum teres uteri and infundibulo-pelvicum, laparoscopic pelvic lymphadenectomy was done. Subsequently vaginal stage of operation was performed. Then we did laparoscopy and controlled operation field again. Combining Schauta operation with laparoscopy allows us to estimate lymph nodes as well as make vaginal phase of operation easier because of mobilization of uterus. We consider that laparoscopic-vaginal radical hysterectomy could be a valuable element in broadening the spectrum of many kinds of operations used in treatment of cervical cancer.
根治性阴道子宫切除术用于宫颈癌的手术治疗已有一百多年的历史。在该手术的普及程度有所下降之后,如今我们可以看到对根治性阴道子宫切除术理念的逐渐回归。先进的腹腔镜技术/淋巴结切除术/与阴道手术相结合的可能性改变了宫颈癌的手术治疗方式。本研究的目的是介绍基于绍陶-阿姆赖希技术的腹腔镜-阴道根治性子宫切除术方法。一名51岁女性入院,根据临床和组织病理学检查诊断为宫颈癌国际妇产科联盟(FIGO)IIA期。我们在全身麻醉下进行了腹腔镜-阴道根治性子宫切除术。首先切断子宫圆韧带和骨盆漏斗韧带后,进行腹腔镜盆腔淋巴结切除术。随后进行手术的阴道阶段。然后我们再次进行腹腔镜检查并检查手术视野。将绍陶手术与腹腔镜检查相结合,使我们能够评估淋巴结,并且由于子宫的游离,使手术的阴道阶段更容易进行。我们认为腹腔镜-阴道根治性子宫切除术可能是拓宽宫颈癌多种手术治疗范围的一个有价值的方法。