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子宫全系膜切除术在早期宫颈癌中的应用

卢艳, 姚德生

卢艳, 姚德生. 子宫全系膜切除术在早期宫颈癌中的应用[J]. 肿瘤防治研究, 2015, 42(08): 852-855. DOI: 10.3971/j.issn.1000-8578.2015.08.022
引用本文: 卢艳, 姚德生. 子宫全系膜切除术在早期宫颈癌中的应用[J]. 肿瘤防治研究, 2015, 42(08): 852-855. DOI: 10.3971/j.issn.1000-8578.2015.08.022
LU Yan, YAO Desheng. Total Mesometrial Resection: A New Technique to Treat Early Stage Cervical Cancer[J]. Cancer Research on Prevention and Treatment, 2015, 42(08): 852-855. DOI: 10.3971/j.issn.1000-8578.2015.08.022
Citation: LU Yan, YAO Desheng. Total Mesometrial Resection: A New Technique to Treat Early Stage Cervical Cancer[J]. Cancer Research on Prevention and Treatment, 2015, 42(08): 852-855. DOI: 10.3971/j.issn.1000-8578.2015.08.022

子宫全系膜切除术在早期宫颈癌中的应用

详细信息
    作者简介:

    卢艳(1975-),女,硕士,副主任医师,主要从事妇科肿瘤的研究

    通讯作者:

    姚德生,E-mail:yaodeson@163.com

  • 中图分类号: R737.33

Total Mesometrial Resection: A New Technique to Treat Early Stage Cervical Cancer

  • 摘要: 传统观念中恶性肿瘤的生长是浸润性生长,是无组织学障碍的,但目前关于恶性肿瘤的生长方式有学者从胚胎学发展角度出发,提出了新的观点,认为恶性肿瘤的生长从胚胎学发展上来说是源于普通原基的“隔间”内限制性生长,由此肿瘤的手术治疗观念也发生了变化,有学者对宫颈癌的手术方式提出了新的理念:子宫全系膜切除术,术后不需要再行补充放射治疗。这种术式在早期宫颈癌的手术治疗中无疑是极富创新性的。

     

    Abstract: According to traditional principles of cancer surgery, tumor growth is undirected perifocal,irrespective of tissue barriers. However, some researches proposed a fresh insight at the anatomy based on embryology. Based on this concept, the current standard practice of local cancer surgery has been developed: total mesometrial resection(TMMR) without adjuvant radiation. This novel concept of embryologically based en bloc resection of a malignant solid tumor along the borders of the morphogenetic unit of its origin will definitely be highly innovative in the surgical treatment of early stage cervical cancer.

     

  • [1] Höckel M, Horn LC, Manthey N, et al. Resection of the embryologically defined uterovaginal(Mullerian) compartment and pelvic control in patients with cervical cancer: a prospective analysis[J]. Lancet Oncol, 2009, 10(7): 683-92.
    [2] Höckel M, Horn LC, Hentschel B, et al. Total mesometrial resection: high resolution nerve-sparing radical hysterectomy based on developmentally defined surgical anatomy[J]. Int J Gynecol Cancer, 2003, 13(6): 791-803.
    [3] Höckel M, Horn LC, Fritsch H. Association between the mesenchymal compartment of uterovaginal organogenesis and local tumour spread in stageⅠB-ⅡB cervical carcinoma: a prospective study[J]. Lancet Oncol, 2005, 6(10): 751-6.
    [4] Höckel M. Do we need a new classification for radical hysterectomy? Insights in surgical anatomy and local tumor spread from human embryology[J]. Gynecol Oncol, 2007,107(1 Suppl 1): S106-12.
    [5] Höckel M. Ultra-radical compartmentalized surgery in gynaecological oncology[J]. Eur J Surg Oncol, 2006, 32(8): 859-65.
    [6] Höckel M, Schmidt K, Bornmann K, et al. Vulvar field resection: novel approach to the surgical treatment of vulvar cancer based on ontogenetic anatomy[J]. Gynecol Oncol, 2010, 119(1): 106-13.
    [7] Querleu D, Morrow CP. Classification of radical hysterectomy[J]. Lancet Oncol, 2008, 9(3): 297-303.
    [8] Sedlis A, Bundy BN, Rotman MZ, et al. A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage ⅠB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: A Gynecologic Oncology Group Study[J]. Gynecol Oncol, 1999, 73(2): 177-83.
    [9] Höckel M, Dornhöfer N. The hydra phenomenon of cancer: why tumors recur locally after microscopically complete resection[J]. Cancer Res, 2005, 65(8): 2997-3002.
    [10] Lai CH, Hong JH, Hsueh S, et al. Preoperative prognostic variables and the impact of postoperative adjuvant therapy on the outcomes of Stage ⅠB or Ⅱ cervical carcinoma patients with or without pelvic lymph node metastases: an analysis of 891 cases [J]. Cancer, 1999, 85(7): 1537-46.
    [11] Kupets R, Thomas GM, Covens A. Is there a role for pelvic lymph node debulking in advanced cervical cancer?[J]. Gynecol Oncol, 20 02, 87(2): 163-70.
    [12] Sakuragi N, Satoh C, Takeda N, et al. Incidence and distribution pattern of pelvic and paraaortic lymph node metastasis in patients with stagesⅠB, ⅡA, andⅡB cervical carcinoma treated with radical hysterectomy[J]. Cancer, 1999, 85(7): 1547-54.
    [13] Manjunath AP, Girija S. Embryologically based resection of cervical cancers: a new concept of surgical radicality[J]. J Obstet Gynaecol India, 2012, 62(1): 5-14.
    [14] Peeters KC, Marijnen CA, Nagtegaal ID, et al. The TME trial after a median follow-up of 6 years: increased local control but no survival benefit in irradiated patients with resectable rectal carcinoma[J]. Ann Surg, 2007, 246(5): 693-701.
    [15] Höckel M, Horn LC, Tetsch E, et al. Pattern analysis of regional spread and therapeutic lymph node dissection in cervical cancer based on ontogenetic anatomy[J]. Gynecol Oncol, 2012, 125(1): 168-74.
    [16] Höckel M. Laterally extended endopelvic resection (LEER)-- principles and practice[J]. Gynecol Oncol, 2008, 111(2 Suppl): S13-7.
    [17] Reza M, Maeso S, Blasco JA, et al. Meta-analysis of observational studies on the safety and effectiveness of robotic gynaecological surgery[J]. Br J Surg, 2010, 97(12): 1772-83.
    [18] Paley PJ, Veljovich DS, Shah CA, et al. Surgical outcomes in gynecologic oncology in the era of robotics: analysis of first 1000 cases[J]. Am J Obstet Gynecol, 2011, 204(6): 551.e1-9.
    [19] Kimmig R, Aktas B, Buderath P, et al. Definition of compartmentbased radical surgery in uterine cancer: modified radical hysterectomy in intermediate/high-risk endometrial cancer using peritoneal mesometrial resection (PMMR) by M Hockel translated to robotic surgery[J]. World J Surg Oncol, 2013, 11: 198.
    [20] [No authors listed] Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial. The EC/IC Bypass Study Group[J]. N Engl J Med, 1985, 313(19): 1191-200.
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出版历程
  • 收稿日期:  2014-07-26
  • 修回日期:  2015-01-29
  • 刊出日期:  2015-08-24

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