Plante M, Roy M
Gynecology Service, L'Hôtel-Dieu de Québec, Laval University, Québec, Canada.
Gynecol Oncol. 1995 Dec;59(3):401-4. doi: 10.1006/gyno.1995.9004.
In patients with suspected recurrent cervical cancer after radiation therapy, it can be very difficult to pathologically confirm recurrence and clinically determine if tumor is resectable via a curative pelvic exenteration. Despite very thorough preoperative investigation uncertainties often remain, so patients ultimately undergo exploratory laparotomy. Unfortunately, inoperable disease is frequently discovered then. We report the use of operative laparoscopy in three patients with recurrent stage IIIB cervical cancer. The age ranged from 38 to 79 years. The mean duration of the procedure was 146 min (range 110-180 min) and blood loss was minimal. The procedure was well tolerated in all patients. There was no intraoperative complication but one deep thrombophlebitis occurred postoperatively. The procedure was successful in all cases in confirming recurrence and selecting out patients who were not surgical candidates for pelvic exenterations. Operative laparoscopy is a less invasive procedure that may be a valuable step in the workup of patients with recurrent cervical cancer. With experience in retroperitoneal surgery, the procedure can be carried out safely. We believe that this approach could prevent unnecessary laparotomies, shorten the hospital stay and the postoperative recovery, and contribute to a better quality of life for women with inoperable disease.
对于接受放疗后疑似复发性宫颈癌的患者，通过病理检查确认复发以及临床判断肿瘤是否可通过根治性盆腔脏器切除术切除非常困难。尽管术前进行了非常全面的检查，但不确定性往往仍然存在，所以患者最终还是要接受剖腹探查术。不幸的是，那时经常会发现疾病无法手术切除。我们报告了对3例复发性IIIB期宫颈癌患者使用手术腹腔镜检查的情况。患者年龄在38岁至79岁之间。手术平均持续时间为146分钟（范围110 - 180分钟），失血量极少。所有患者对该手术耐受性良好。术中无并发症，但术后发生了1例深部血栓性静脉炎。该手术在所有病例中均成功确认了复发，并筛选出不适合进行盆腔脏器切除术的患者。手术腹腔镜检查是一种侵入性较小的手术，可能是复发性宫颈癌患者检查过程中的一个有价值的步骤。有腹膜后手术经验的话，该手术可以安全实施。我们认为这种方法可以避免不必要的剖腹探查术，缩短住院时间和术后恢复时间，并有助于提高无法手术切除疾病的女性的生活质量。
