A new proposal for radical hysterectomy
A new proposal for radical hysterectomy
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DOI：
10.1006/gyno.1996.0251
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发表时间：
1996-09-01
影响因子：
4.7
通讯作者：
Satou, N
中科院分区：
文献类型：
--
作者：
Yabuki, Y;Asamoto, A;Satou, N
目的：作者通过对子宫支架内静脉系统、结缔组织筋膜和神经通路的详细观察，修改了根治性子宫切除术的手术方法。研究设计：将子宫前、中、后支架重新分类为两种系统：筋膜支撑系统和引流系统。支撑系统由膀胱外线韧带的浅层、Mackenrodt韧带的筋膜部分、骶髂韧带和直肠阴道韧带组成，而引流系统由膀胱外线韧带的深层、Mackenrodt韧带的血管部分和所谓的中系膜组成。根据这些韧带的连续性计划手术步骤，先切除筋膜，然后解剖脱落的口腔组织。15个病人手术对子宫癌症在2年期间操作所需的平均(SD)时间是305.5 + / - 30.5分钟,平均(SD)总量失血592.0 + / - 238.2毫升,平均(SD) 14.3 + / - 3.8术后天需要直到残余尿液的体积下降到不到50毫升。结论:目前的操作系统结构更规整,比以前。此外，手术的安全性显著提高，包括预防出血和膀胱功能的保存。(C) 1996学术出版社，Inc.
Objective: The authors revised the surgical procedure for radical hysterectomy utilizing detailed observation of the venous system, connective fascial sheets, and neural pathways within the uterine supports. Study design: The anterior, middle, and, posterior uterine supports were reclassified into two systems, supporting or fascial and drainage or areoral. Supporting system consisted of the superficial layer of the vesicouterine ligament, fascial part of the Mackenrodt ligament, sacrouterine ligament, and rectovaginal Ligament, whereas drainage system consisted of the deep layer of the vesicouterine Ligament, vascular part of the Mackenrodt ligament, and the so-called mesoureter, The operative procedure was planned according to the continuity of these ligaments and executed first by excising the fascia and then dissecting the denuded areoral tissue, Results: Among the 15 patients who underwent surgery for uterine cancer during a 2-year period the mean (SD) time required for the operation was 305.5 +/- 30.5 min and the mean (SD) total volume of blood loss 592.0 +/- 238.2 ml. A mean (SD) period of 14.3 +/- 3.8 postoperative days was required until the volume of the residual urine decreased to less than 50 ml. Conclusion: The present operation has been structured more three-dimensionally and systematically than before. Further, safety of the operation was significantly improved including prevention of hemorrhage and preservation of bladder function. (C) 1996 Academic Press, Inc.