Nasser Sara, Almuheimid Jumana, Plett Helmut, Sehouli Jalid, Muallem Mustafa Zelal
Department of Gynecology, Campus Virchow-Klinikum, Charité Medical University, Berlin, Germany.
Department of Gynecology, Campus Virchow-Klinikum, Charité Medical University, Berlin, Germany
Anticancer Res. 2016 Sep;36(9):4903-7. doi: 10.21873/anticanres.11055.
In this study we aimed to analyze the safety and feasibility of total mesometrial resection (TMMR) using the laparoscopic approach.
Laparoscopic TMMR and pelvic lymphadenectomy (LNE) was carried out in 34 patients with cervical cancer FIGO IA-IIB from April 2012-April 2016 at our tertiary center. Para-aortic LNE was performed when indicated. The main outcomes included surgical margins, a number of retrieved lymph node, intra- and post-operative complications, and recurrence rates.
Complete microscopic tumor resection was confirmed in 33/34 (97%) patients. No conversion to open surgery was necessary. Mean intra-operative blood loss was only 65.2 ml with no blood transfusions required. Intra-operative complications occurred in 4/34 (11.8%) cases (2 bladder injuries and 2 ureteric injuries). Post-operative complications were observed in 10/35 (29.4%) cases. Only one complication occurred after 30 days (vesico-vaginal fistula). There was a loco-regional recurrence within a mean follow-up time of 25.9 months.
Laparoscopic TMMR appears to be feasible and safe in the treatment of early-stage cervical cancer. Further large-scale studies are required.
本研究旨在分析采用腹腔镜入路行全子宫系膜切除术（TMMR）的安全性和可行性。
2012年4月至2016年4月期间，在我们的三级医疗中心，对34例国际妇产科联盟（FIGO）IA-IIB期宫颈癌患者实施了腹腔镜TMMR及盆腔淋巴结切除术（LNE）。必要时进行腹主动脉旁LNE。主要观察指标包括手术切缘、获取的淋巴结数量、术中及术后并发症以及复发率。
33/34（97%）例患者证实实现了显微镜下肿瘤完全切除。无需转为开腹手术。术中平均失血量仅65.2毫升，无需输血。4/34（11.8%）例发生术中并发症（2例膀胱损伤和2例输尿管损伤）。10/35（29.4%）例观察到术后并发症。仅1例在30天后出现并发症（膀胱阴道瘘）。在平均25.9个月的随访时间内出现了局部区域复发。
腹腔镜TMMR在早期宫颈癌治疗中似乎可行且安全。需要进一步开展大规模研究。
