Querleu D, Leblanc E, Castelain B
Service de Chirurgie Gynécologique-Cancérologie, Pavillon Paul-Gellé, Roubaix.
Ann Chir. 1994;48(10):930-5.
Laparoscopic surgery occupies an increasingly important place in the diagnosis and staging of gynaecological cancers. It allows repeated complete investigation of the abdomen and retroperitoneum: macroscopic examination of the peritoneum, cytology, biopsies, infracolonic omentectomy, appendicectomy, pelvic and para-aortic lymphadenectomy, without interfering with therapeutic procedures (simple or radical hysterectomy) which can be associated. In cancers of the endometrium, it is part of a surgical strategy associating vaginal hysterectomy. In ovarian cancers, it is essentially applied to restaging of insufficiently explored apparent stage I tumours. In operable cervical cancer, it guides the therapeutic protocol and surgical indication by allowing interiliac lymphadenectomy. In advanced cervical cancers, it is used to detect para-aortic lymph nodes.
腹腔镜手术在妇科癌症的诊断和分期中占据着越来越重要的地位。它能对腹部和腹膜后进行反复全面检查：包括腹膜的宏观检查、细胞学检查、活检、结肠下网膜切除术、阑尾切除术、盆腔及腹主动脉旁淋巴结切除术，且不会干扰与之联合的治疗程序（单纯或根治性子宫切除术）。在子宫内膜癌中，它是联合经阴道子宫切除术的手术策略的一部分。在卵巢癌中，它主要用于对探查不充分的明显Ⅰ期肿瘤进行再分期。在可手术的宫颈癌中，通过进行髂间淋巴结切除术来指导治疗方案和手术指征。在晚期宫颈癌中，它用于检测腹主动脉旁淋巴结。
