Abstract：
Vaginal stump recurrence post-hysterectomy for gynecologic malignancies occurs in 2%-3% of cases. Local excision has been recognized as the primary treatment of localized recurrence, in which precise surgical margin is critical. However, R0 resection is not always easy, given the deep and narrow operation field, as well as severe postoperative fibrosis or adhesion of the vaginal stump at times. Here, we report four cases of vaginal stump recurrence of gynecologic malignancies resected by bi-directional (laparoscopic and pneumovaginoscopic) endoscopy to overcome these difficulties. The primary tumors were uterine cancer in two cases and uterine cervical and ovarian cancer in one case each. The mean operating time was 199 (162-235) minutes, blood loss was minimal, and no perioperative complications were observed. Postoperative follow-up (7.0-19.4 months) revealed no recurrence. This combined procedure could be a therapeutic option for localized vaginal stump recurrence.
摘要：
2％-3％的妇科恶性肿瘤子宫切除术后阴道残端复发。局部切除已被认为是局部复发的主要治疗方法，其中精确的手术切缘至关重要。然而,R0切除并不总是那么容易，鉴于作业领域又深又窄，以及严重的术后纤维化或阴道残端粘连。这里,我们报告了4例妇科恶性肿瘤阴道残端复发的病例，通过双向（腹腔镜和气阴镜）内镜切除以克服这些困难。原发肿瘤为子宫癌2例,子宫癌和卵巢癌各1例。平均手术时间为199（162-235）分钟，失血很少,未观察到围手术期并发症。术后随访7.0～19.4个月无复发。这种联合手术可能是局部阴道残端复发的治疗选择。
