腹腔镜手术治疗妇科恶性肿瘤48例临床分析(4)
3.4 腹腔镜下妇科恶性肿瘤手术的准入标准 腹腔镜下妇科恶性瘤手术并不是完全取决于腹腔镜手术的技术,更重要的是取决于妇科恶性肿瘤治疗的整体理念,更确切地说是指术者对于解剖的了解程度,对于妇科肿瘤手术的掌握程度,对于妇科肿瘤手术中的意外情况的处理水平,因此许多国家都制订了关于妇科恶性肿瘤腹腔镜手术的准入标准。综合起来主要有3个标准:(1)妇科肿瘤医生或接受了完整的妇科肿瘤手术培训的妇科医生,本身能够胜任妇科肿瘤的各项开腹手术;(2)接受了完整的腹腔镜常规手术的培训,已经很好地掌握了腹腔镜手术的各项技术;(3)必须胜任各种补救措施,主要指血管或其他重要器官的损伤的处理。
腹腔镜下妇科恶性肿瘤手术范围广,风险大,并发症多,只有术者不断提高操作水平和处理手术并发症的能力以及医院逐步规范的手术流程,才能降低术中并发症的发生率并真正推进腹腔镜治疗妇科恶性肿瘤。
腹腔镜下根治性宫颈切除术、单孔腹腔镜下恶性肿瘤手术、双孔腹腔镜下恶性肿瘤手术、机器人辅助腹腔镜在妇科恶性肿瘤中的应用均是当前研究的热门课题[22-28],笔者期待有更多的成果来指导妇科恶性肿瘤的治疗。
, 百拇医药
参考文献
[1] Wright J D,Hershman D L,Burke W M,et al.Influence of surgical volume on outcome for lapamscopic hysterectomy for endometrial cancer[J].Annals of Surgical Oncology,2012,19(3):948-958.
[2] Suh D H,Kim J W,Aziz M F,et al.Asian society of gynecologic-oncology workshop 2010[J].J Gynecol Oncol,2010,21(3):137-150.
[3] Taylor S E,Mc Bee WC Jr,Richard S D,et al.Radical hysterectomy for early stage cervical cancer:laparoscopy versus laparotomy[J].JSLS,2011,15(2):213-217.
, 百拇医药
[4] Eltabbakh G H,Mount S L.Laparoscopic surgery does not increase the positive peritoneal cytology among women with endometrial carcinoma[J].Gynecol Oncol,2006,100(2):361-364.
[5] Qvigstad E,Lieng M.Surgical treatment of endometrial cancer and atypical hyperplasia:a trend shift from laparotomy to laparoscopy[J].Ohstet Gynecol Int,2011,2011(45):829 425.
[6] Weber S,Mc Cann C K,Boruta D M,et al.Laparoscopic surgical staging of early ovarian cancer[J].Rev Obstet Gynecol,2011,4(3-4):117-122.
, http://www.100md.com
[7] Reich H,Mc Glynn F,Wilkie W.Laparoscopic management of stage I ovarian cancer.A case report[J].J Reprod Med,1990,35(6):601-604.
[8] Li A J,Karlan B Y.Surgical advances in the treatment of ovarian cancer[J].Hematol Oncol Clin North Am,2003,17(4):945-956.
[9] Park H J,Kim D W,Yim G W,et al.Staging laparoscopy for the management of early-stage ovarian cancer:a metaanalysis[J].Am J Obstet Gynecol,2013,209(1):58.
, http://www.100md.com
[10] Lee M,Kim S W,Paek J,et al.Comparisons of surgical outcomes,complications,and costs between laparotomy and laparoscopy in early-stage ovarian cancer[J].Int J Gynecol Cancer,2011,21(2):251-256.
[11] Park J Y,Kim D Y,Suh D S,et al.Comparison of laparoscopy and laparotomy in surgical staging of early-stage ovarian and fallopian tubal cancer[J].Ann Surg Oncol,2008,15(7):2012-2019.
[12] Jung U S,Lee J H,Kyung M S,et al.Feasibility and efficacy of laparoscopic management of ovarian cancer[J].J Obstet Gynaecol Res,2009,35(1):113-118., http://www.100md.com(倪琴 米鑫 张风格)
腹腔镜下妇科恶性肿瘤手术范围广,风险大,并发症多,只有术者不断提高操作水平和处理手术并发症的能力以及医院逐步规范的手术流程,才能降低术中并发症的发生率并真正推进腹腔镜治疗妇科恶性肿瘤。
腹腔镜下根治性宫颈切除术、单孔腹腔镜下恶性肿瘤手术、双孔腹腔镜下恶性肿瘤手术、机器人辅助腹腔镜在妇科恶性肿瘤中的应用均是当前研究的热门课题[22-28],笔者期待有更多的成果来指导妇科恶性肿瘤的治疗。
, 百拇医药
参考文献
[1] Wright J D,Hershman D L,Burke W M,et al.Influence of surgical volume on outcome for lapamscopic hysterectomy for endometrial cancer[J].Annals of Surgical Oncology,2012,19(3):948-958.
[2] Suh D H,Kim J W,Aziz M F,et al.Asian society of gynecologic-oncology workshop 2010[J].J Gynecol Oncol,2010,21(3):137-150.
[3] Taylor S E,Mc Bee WC Jr,Richard S D,et al.Radical hysterectomy for early stage cervical cancer:laparoscopy versus laparotomy[J].JSLS,2011,15(2):213-217.
, 百拇医药
[4] Eltabbakh G H,Mount S L.Laparoscopic surgery does not increase the positive peritoneal cytology among women with endometrial carcinoma[J].Gynecol Oncol,2006,100(2):361-364.
[5] Qvigstad E,Lieng M.Surgical treatment of endometrial cancer and atypical hyperplasia:a trend shift from laparotomy to laparoscopy[J].Ohstet Gynecol Int,2011,2011(45):829 425.
[6] Weber S,Mc Cann C K,Boruta D M,et al.Laparoscopic surgical staging of early ovarian cancer[J].Rev Obstet Gynecol,2011,4(3-4):117-122.
, http://www.100md.com
[7] Reich H,Mc Glynn F,Wilkie W.Laparoscopic management of stage I ovarian cancer.A case report[J].J Reprod Med,1990,35(6):601-604.
[8] Li A J,Karlan B Y.Surgical advances in the treatment of ovarian cancer[J].Hematol Oncol Clin North Am,2003,17(4):945-956.
[9] Park H J,Kim D W,Yim G W,et al.Staging laparoscopy for the management of early-stage ovarian cancer:a metaanalysis[J].Am J Obstet Gynecol,2013,209(1):58.
, http://www.100md.com
[10] Lee M,Kim S W,Paek J,et al.Comparisons of surgical outcomes,complications,and costs between laparotomy and laparoscopy in early-stage ovarian cancer[J].Int J Gynecol Cancer,2011,21(2):251-256.
[11] Park J Y,Kim D Y,Suh D S,et al.Comparison of laparoscopy and laparotomy in surgical staging of early-stage ovarian and fallopian tubal cancer[J].Ann Surg Oncol,2008,15(7):2012-2019.
[12] Jung U S,Lee J H,Kyung M S,et al.Feasibility and efficacy of laparoscopic management of ovarian cancer[J].J Obstet Gynaecol Res,2009,35(1):113-118., http://www.100md.com(倪琴 米鑫 张风格)