Tanaka Tomohito, Terai Yoshito, Maeda Kazuya, Ashihara Keisuke, Kogata Yuhei, Maruoka Hiroshi, Terada Shinichi, Yamada Takashi, Ohmichi Masahide
Department of Obstetrics and Gynecology Department of Pathology, Osaka Medical College, Takatsuki, Osaka, Japan.
Medicine (Baltimore). 2017 Jul;96(27):e7502. doi: 10.1097/MD.0000000000007502.
The aim of this study was to evaluate the dissemination of cancer cells at laparoscopic hysterectomy according to the intraperitoneal cytology.Patients with endometrial cancer underwent total laparoscopic modified radical hysterectomy. Peritoneal wash cytology was performed on entering the peritoneal cavity before surgical preparation and just after hysterectomy.Seventy-eight patients underwent laparoscopic hysterectomy for endometrial cancer. Among the 15 patients who had positive intraperitoneal cytology on entering the peritoneal cavity, 10 converted to negative intraperitoneal cytology after hysterectomy. In contrast, among the 63 patients who had negative intraperitoneal cytology on entering the peritoneal cavity, 2 converted to positive intraperitoneal cytology after hysterectomy.While surgery can reduce the number of cancer cells in the peritoneal cavity, leakage can occur, as seen in some cases of hysterectomy. Careful washing must be performed after hysterectomy.
本研究的目的是根据腹腔细胞学评估腹腔镜子宫切除术中癌细胞的播散情况。子宫内膜癌患者接受了全腹腔镜改良根治性子宫切除术。在手术准备前进入腹腔时以及子宫切除术后立即进行腹腔冲洗细胞学检查。78例患者因子宫内膜癌接受了腹腔镜子宫切除术。在进入腹腔时腹腔细胞学检查呈阳性的15例患者中，10例在子宫切除术后腹腔细胞学检查转为阴性。相比之下，在进入腹腔时腹腔细胞学检查呈阴性的63例患者中，2例在子宫切除术后腹腔细胞学检查转为阳性。虽然手术可以减少腹腔内癌细胞的数量，但如某些子宫切除病例所示，仍可能发生渗漏。子宫切除术后必须进行仔细冲洗。
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