腹腔镜下宫颈癌保留生育功能手术中闭孔神经损伤
Laparoscopic injury of the obturator nerve during fertility-sparing procedure for cervical cancer.
机构信息
Department of Obstetrics and Gynecology, Sapienza University of Rome, Sant'Andrea Hospital, via di Grottarossa, 1035-1039, Rome 00189, Italy.
出版信息
World J Surg Oncol. 2012 Aug 30;10:177. doi: 10.1186/1477-7819-10-177.
BACKGROUND
Intraoperative injury of the obturator nerve has rarely been reported in patients with gynecological malignancies undergoing extensive radical surgeries. Irreversible damage of this nerve causes thigh paresthesia and claudication. Intraoperative repair may be done by end-to-end anastomosis or grafting when achieving tension-free anastomosis is not possible.
CASE PRESENTATION
A 28-year-old woman with stage IB cervical cancer underwent fertility-sparing surgery, including conization and bilateral pelvic lymphadenectomy. The left obturator nerve was damaged intraoperatively during pelvic dissection.
CONCLUSION
Immediate laparoscopic repair was successful and there was no functional deficit in the left thigh for six months postoperatively.
背景
在行广泛根治性手术的妇科恶性肿瘤患者中，偶有报道术中坐骨神经损伤。该神经一旦发生不可逆转损伤，可导致大腿感觉异常和跛行。当无法实现无张力吻合时，可进行端端吻合或移植进行术中修复。
病例介绍
一位 28 岁的宫颈癌 IB 期患者行保留生育功能手术，包括子宫颈锥形切除术和双侧盆腔淋巴结切除术。在盆腔解剖过程中，左侧闭孔神经受损。
结论
术后 6 个月，腹腔镜即时修复成功，左大腿无功能缺损。
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