Lang J F, Childers J M, Surwit E A
Department of Obstetrics and Gynecology, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ 85724, USA.
J Am Assoc Gynecol Laparosc. 1995 Aug;2(4):475-7. doi: 10.1016/s1074-3804(05)80074-x.
We performed laparoscopic hysterectomy in a woman with persistent gestational trophoblastic neoplasia. The procedure offered advantages over vaginal hysterectomy in that intraabdominal inspection was possible, morcellation was avoided, and the uterine arteries were transected before uterine manipulation to avoid potential tumor embolization. In addition, an abdominal incision was not required, and the patient had shorter hospitalization and less pain than she would have had with the standard abdominal procedure. Persistent, locally invasive gestational trophoblastic neoplasia (GTN) develops in 15% of women after dilatation and evacuation for molar pregnancy. Chemotherapy and hysterectomy are curative in virtually all patients. Numerous factors are considered in deciding the primary mode of therapy. Women in whom fertility is not an issue may choose hysterectomy, which decreases the amount of chemotherapy required to achieve cure. Traditionally, this has been performed with an abdominal approach. We performed laparoscopic hysterectomy to manage GTN.
我们对一名患有持续性妊娠滋养细胞肿瘤的女性实施了腹腔镜子宫切除术。该手术相对于经阴道子宫切除术具有优势，因为可以进行腹腔内检查，避免了碎瘤操作，并且在子宫操作前切断子宫动脉以避免潜在的肿瘤栓塞。此外，无需腹部切口，与标准腹部手术相比，患者住院时间更短，疼痛更少。在15%因葡萄胎行刮宫术的女性中会发生持续性、局部侵袭性妊娠滋养细胞肿瘤（GTN）。化疗和子宫切除术实际上对所有患者都有治愈作用。在决定主要治疗方式时会考虑众多因素。对于生育不是问题的女性，可以选择子宫切除术，这可减少达到治愈所需的化疗量。传统上，这是通过腹部入路进行的。我们实施腹腔镜子宫切除术来治疗GTN。
