Induction of total laparoscopic hysterectomy adopted the marionette technique in peri-menopausal and post-menopausal CIN3 patients

作     者：Tomonori Nagai Kousuke Shigematsu Yuichiro Kizaki Yoshiko Kurose Koki Samejima Takahiro Uotani Taichi Akahori Shigetaka Matsunaga Yasushi Takai Tomonori Nagai;Kousuke Shigematsu;Yuichiro Kizaki;Yoshiko Kurose;Koki Samejima;Takahiro Uotani;Taichi Akahori;Shigetaka Matsunaga;Yasushi Takai

作者机构：Department of Obstetrics and GynecologySaitama Medical CenterSaitama Medical UniversitySaitama350-8550Japan 

出 版 物：《Laparoscopic, Endoscopic and Robotic Surgery》 (腔镜、内镜与机器人外科（英文）)

年 卷 期：2022年第5卷第1期

页      面：15-18页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Cervical intraepithelialneoplasia Cervical stenosis Total laparoscopic hysterectomy 

摘      要：Objective:When performing cervical conization in post-menopausal cervical intraepithelial neoplasia 3(CIN3)patients,the positive rate of endocervical cone margin and the incidence of postoperative cervical stenosis *** study summarized a 4-year experience of total laparoscopic hysterectomy as a treatment option for peri-menopausal and post-menopausal CIN3 patients at a single ***,it shared the refinement strategies used during the ***:This study retrospectively analyzed the medical records of CIN3 patient aged
45 years and who underwent open or laparoscopic hysterectomy at our institution from January 1,2017 to December 31,***,30 CIN3 patients were enrolled and divided into abdominal hysterectomy group and laparoscopic hysterectomy based on surgery method,with 5 patients and 25 patients ***:Compared to the abdominal hysterectomy group,the perioperative blood loss(20 mL vs.220 mL,p=0.004)was less and the duration of in-hospital stay(7 d vs.11 d,p0.001)were significantly shorter in the laparoscopic hysterectomy ***,no significant differences in age at hysterectomy(53 y vs.77 y,p=0.054)and operative time(154.4±27.8 min vs.161.0±62.4 min,p=0.826)were observed between *** conization was performed in advance for 12 patients,and among them,10(83.3%)patients had positive endocervical cone *** intestinal obstructionwas noted in one abdominal hysterectomy patient,no other complications were observed in the remaining ***:Compared to conization,hysterectomy is more invasive;however,it is an acceptable treatment option for peri-menopausal and post-menopausal CIN3 *** such cases,opting for total laparoscopic hysterectomy adopted the marionette technique might be preferable because the procedure is less invasive.