Canis M, Mage G, Wattiez A, Pouly J L, Glowaczover E, Raiga J, Bruhat M
Service de Gynécologie Obstétrique et Biologie de la Reproduction Polyclinique de L'Hotel Dieu, Clermont Ferrand, France.
Curr Opin Obstet Gynecol. 1994 Jun;6(3):210-4.
As a result of recent technological advances, laparoscopic lymphadenectomy is becoming the standard method for the staging of pelvic cancer. More extensive procedures, such as para-aortic lymph node dissection and radical hysterectomy, have also been demonstrated to be feasible by advanced laparoscopic surgery. This new approach appears to be very promising. In the future, because of its well documented advantages, laparoscopic surgery may appear as a way to decrease the morbidity of cancer treatment in patients with low-risk tumors and to propose more aggressive treatments of patients with tumors associated with a poor prognosis. These new techniques should be reserved for surgical teams trained in oncologic and major laparoscopic surgery. More clinical research is required before this approach can be proposed as an alternative to laparotomy, and guidelines have to be established. Training in oncology is essential to ensure optimal patient care and to avoid the consequences of inadequate laparoscopic management with regard to cases of tumor dissemination reported after laparoscopic biopsy or resection of undiagnosed ovarian cancer.
由于近期的技术进步，腹腔镜淋巴结切除术正成为盆腔癌分期的标准方法。更广泛的手术，如腹主动脉旁淋巴结清扫术和根治性子宫切除术，也已被证明可通过先进的腹腔镜手术实现。这种新方法似乎非常有前景。未来，由于其已被充分证明的优势，腹腔镜手术可能成为降低低风险肿瘤患者癌症治疗发病率以及对预后不良肿瘤患者采取更积极治疗的一种方式。这些新技术应仅由接受过肿瘤学和大型腹腔镜手术培训的手术团队使用。在这种方法被提议作为开腹手术的替代方法之前，还需要更多的临床研究，并且必须制定指南。肿瘤学培训对于确保最佳的患者护理以及避免因腹腔镜活检或未确诊卵巢癌切除术后报告的肿瘤播散病例中腹腔镜处理不当而产生的后果至关重要。
