Surgical treatment of endometrial cancer, endometrial cancer, surgery is the main treatment, the main basis for the choice of surgical preoperative clinical stage, intraoperative exploration, peritoneal lavage fluid cytology, visual inspection and frozen uterus biopsy results and the patient's age, general health, with or without medical complications and other circumstances determine extent of surgery.
1. Surgical indications and contraindications
(1) indications consistent with Fl clinical stage I, E and part of E of the can tolerate surgery.
(2) N periods and because of contraindications associated with severe, surgical disease can not tolerate surgery in all of the cases.
2. Surgical procedures
Pathologically confirmed, in accordance with the following selection of surgical clinical stage:
(1) fascia abdominal hysterectomy and two outside oophorectomy, pelvic and aortic lymph node dissection or biopsy, and for endometrial cancer and endometrial cancer, I E of the whole volume of radiotherapy. After the surgery, including abdominal delivery abdominal lavage cytology, total hysterectomy and double oophorectomy, excision of the uterus to cut Palace than benign, and resection of the vaginal wall 1 – 2cm, ovarian vein ligation, pelvic and para-aortic lymph node dissection or sampling and surgery. At present, most people believe that the treatment of retroperitoneal lymph node dissection meaning hard to sure, generally do not advocate routine lymph node dissection.
Prognostic factors containing one of the following retroperitoneal lymph node dissection: poorly differentiated tumors. deep myometrial invasion. cervical involvement. serous adenocarcinoma or clear cell carcinoma.
(2) radical hysterectomy, removal of double attachment, pelvic and abdominal para-aortic lymphadenectomy for endometrial cancer in patients with E. Surgery involves removing the uterus and two annexes, all uterine tissue ,3 — 4cm long section of the vagina, ovarian vein ligation and pelvic and abdominal aortic dissection. Patients according to clinical stage and pathological findings further discretion, if the high-risk group was further supplemented by intracavitary irradiation, pelvic radiation or chemotherapy, hormone therapy.
(3) cytoreductive surgery for endometrial cancer, E or N of the foci of radiotherapy are reduced. Surgical removal of the visible range is possible, so as to achieve microscopic level of cancer, postoperative radiotherapy, chemotherapy, hormone and other comprehensive treatment.
3. Surgical complications
Surgical treatment of endometrial cancer, endometrial cancer patients with extensive E of hysterectomy and pelvic lymph node dissection (radical hysterectomy), the surgical complications of cervical cancer with the aforementioned complications.