Wang P H, Yuan C C, Chao K C, Yen M S, Ng H T, Chao H T
Department of Obstetrics and Gynecology, Veterans General Hospital, Taipei, National Yang-Ming University School of Medicine, Taiwan, R.O.C.
J Reprod Med. 1997 Dec;42(12):801-4.
Although more than 50 cases of recurrence at the sites of cannula insertion after laparoscopy for malignant tumors have been reported in the literature, the majority were adenocarcinoma. We report a case of intraperitoneal carcinomatosis and abdominal wall metastases of the trocar site after laparoscopically assisted radical vaginal hysterectomy for the treatment of squamous cell carcinoma of the cervix.
A 47-year-old woman underwent curative, laparoscopically assisted radical vaginal hysterectomy and pelvic lymphadenectomy for treating squamous cell carcinoma of the cervix, stage IB. The postoperative course was uneventful until two months later when abdominal recurrences at the trocar site and diffuse peritoneal carcinomatosis were noted. Pathology proved recurrent intraperitoneal squamous cell carcinoma with invasion of the abdominal port site.
This case further alerts gynecologic oncologists of the potential risks of laparoscopic surgery for potentially curable gynecologic malignancies.
虽然文献中已报道了50多例腹腔镜治疗恶性肿瘤后套管插入部位复发的病例，但大多数为腺癌。我们报告1例腹腔镜辅助根治性阴道子宫切除术后发生腹膜内癌病和套管针穿刺部位腹壁转移的病例，该病例为宫颈鳞状细胞癌。
一名47岁女性因治疗IB期宫颈鳞状细胞癌接受了根治性腹腔镜辅助根治性阴道子宫切除术和盆腔淋巴结清扫术。术后过程平稳，直到两个月后发现套管针穿刺部位出现腹部复发和弥漫性腹膜癌病。病理证实为复发性腹膜内鳞状细胞癌，侵犯腹部穿刺部位。
本病例进一步提醒妇科肿瘤学家，对于潜在可治愈的妇科恶性肿瘤，腹腔镜手术存在潜在风险。
