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目的探讨经阴道手术辅助腹腔镜前盆腔脏器切除的手术方法。方法女性患者7例(浸润性膀胱癌6例,宫颈癌侵犯膀胱1例),年龄52～73岁,平均63岁。腹腔镜下行双侧盆腔淋巴结清扫及子宫、膀胱的游离与相关韧带的切断。经阴道直视下剪开阴道前后穹窿取出标本并缝合阴道。结果手术全部取得成功,无中转开腹者。手术时间2～4.5h,平均3.2h;出血量450～1100mL,平均560mL。术后随访3～14个月,所有患者均存活。宫颈癌患者于术后7个月出现局部复发,1例膀胱癌患者于术后第8个月发现肝脏转移。结论经阴道手术辅助腹腔镜前盆腔脏器切除是治疗膀胱及子宫恶性肿瘤可行而有效的方法。
Objective To investigate the surgical methods of transvaginal laparoscopic anterior pelvic organ assisted surgery. Methods 7 cases of female patients (invasive bladder cancer in 6 cases, cervical cancer invaded the bladder in 1 case), aged 52 to 73 years, mean 63 years. Laparoscopic bilateral pelvic lymph node dissection and uterine, bladder free and related ligament cut off. Transvaginal vision before and after vaginal incision to remove the vaginal fornix and suture the vagina. Results of all the successful surgery, no transit oppression who. Surgery time 2 ~ 4.5h, an average of 3.2h; amount of bleeding 450 ~ 1100mL, an average of 560mL. All the patients survived after 3-14 months of follow-up. Cervical cancer patients experienced local recurrence 7 months after surgery, and 1 case of bladder cancer found liver metastasis at 8 months after surgery. Conclusion Transvaginal surgery assisted laparoscopic pelvic organ resection is a feasible and effective method for the treatment of bladder and uterine malignancies.