Tài liệu Hội thảo Quốc tế về Nội soi và Phẫu thuật nội soi
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<b>Laparoscopic Radical </b>
<b>Hysterectomy </b>
<b>in </b>
<b>Cervical Cancer </b>
Aranya Yantapant , MD
Obtetric – Gynecology Department
Rajavithi Hospital Thailand
<b>Definition </b>
Is a malignant neoplasm arising
from cells originating in the cervix
uteri.
Most common symptom is
abnormal vaginal bleeding
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<b>Concurrent chemoradiation </b>
<b>Radiation </b>
<b>Chemotherapy </b>
<b>Stage </b>
<b>Treatment </b>
<b>IA1-fertility</b>
<b> -complete family</b>
<b>LEEP or conization </b>
<b>Extrafascial hysterectomy </b>
<b>IA2- fertility</b>
<b> </b>
<b> -complete family </b>
<b>Conization and extraperitoneal </b>
<b>lymphadenectomy </b>
<b>Hysterectomy type II with pelvic </b>
<b>node lymphadenectomy </b>
<b>IB-IIA </b> <b>Radical hysterectomy with </b>
<b>pelvic node lymphadenectomy </b>
<b>IIB-IVA </b>
<b>IVB </b>
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<b>Cancer in Thailand </b>
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Laparoscopic surgery
<b>Explor laparotomy </b>
<b>Cervical Cancer </b>
<b>in </b>
<b>Rajavithi Hospital </b>
2006-2013 for laparoscopic surgery
LRHND 2010
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<b>Laparoscopic surgery </b>
Stage Ia1-IB1
CT whole abdomen
Age < 65 years
No contraindications
BMI < 35
<b>stage </b>
<b>Ia1 </b>
<b>Ia2 </b>
<b>Ib1 </b>
numbers 7 2 17
<b>Procedures </b> <b>TLH </b> <b>LMRHND </b> <b>LRHND </b>
number 7 2 17
<b>Blood loss </b> <b>TLH </b> <b>LMRHND </b> <b>LRHND </b>
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<b>Complications </b>
Urinary tract infection
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Tear left ureter
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Tissue emphysema
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<b>Operative time </b>
<b>TLH </b>
<b>LMRHND </b>
<b>LRHND </b>
<b>hours </b> <b>3.4-7.3(4.8) </b> <b>4.45-5.25(4.85) </b> <b>4.14-8(5.53) </b>
<b>Hospitalization TLH </b>
<b>LMRHND LRHND </b>
days
3-9(9.8)
4-9(6.5)
5-22(12.8)
<b>Follow up </b>
<b>TLH </b>
<b>LMRHND </b>
<b>LRHND </b>
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<b>Recurrence </b>
IB1
27-7
27-18 Pelvic node metastasis
11-8
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<b>1 uterine elevator </b>
<b>2 intraabdominal organ evaluation </b>
<b>3 development of the paravesicle </b>
<b>and pararectal spaces </b>
<b>4. Pelvic lymphadenectomy </b>
<b>5. Mobilization of the bladder </b>
<b>from the proximal vagina </b>
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<b>7. Ligation and division of the uterine </b>
<b>artery </b>
<b>8. Dissection of the vesicouterine ligament </b>
<b>9. Posterior dissection showing </b>
<b>uterosacral ligament and rectovaginal </b>
<b>space </b>
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