1. Vaginal Hysterectomy for Endometrial Cancer Peng-Hui Wang Department of Obstetrics and Gynecology Taipei Veterans General Hospital National Yang-Ming University School of Medicine 王 鵬 惠 台北榮民總醫院婦產部暨國立陽明大學醫學院婦產科學系 3 September 2008

2. 王 鵬 惠王 鵬 惠王 鵬 惠王 鵬 惠

3. 王 鵬 惠王 鵬 惠王 鵬 惠王 鵬 惠 這個回顧性研究顯示經由陰道全子宮切 除，可以適用在一些子宮內膜癌的病人 AJOG 2007;197:202e1-202e7.

4. 王 鵬 惠王 鵬 惠王 鵬 惠王 鵬 惠 Several authors have described vaginal hysterectomy as a reasonable alternative to other surgical methods for the treatment of endometrial cancer, especially in the morbidly obese, elderly, medically compromised, or otherwise poor surgical candidate. For these selected patients, disease-free and overall survival have been similar in women treated with abdominal surgery. 前言 Gynecol Oncol 2005;96:362-7. Obstet Gynecol 2001;97(5 Pt 1):707-11.

5. 王 鵬 惠王 鵬 惠王 鵬 惠王 鵬 惠 Medical records were retrospectively reviewed for patients undergoing vaginal hysterectomy for endometrial cancer at the University of South Florida. The medical data were reviewed for medical comorbidities, preoperative and postoperative diagnosis, hospital course, surgical and postoperative complications, adjuvant treatments, and follow-up. 方法 AJOG 2007;197:202e1-202e7.

6. 王 鵬 惠王 鵬 惠王 鵬 惠王 鵬 惠 結果

7. 王 鵬 惠王 鵬 惠王 鵬 惠王 鵬 惠 結果

8. 王 鵬 惠王 鵬 惠王 鵬 惠王 鵬 惠

9. 王 鵬 惠王 鵬 惠王 鵬 惠王 鵬 惠 結果

10. 王 鵬 惠王 鵬 惠王 鵬 惠王 鵬 惠 結果 75.5%: low risk or intermediate “low” risk

11. 王 鵬 惠王 鵬 惠王 鵬 惠王 鵬 惠 AJOG 2007;197:202e1-202e7.

12. 王 鵬 惠王 鵬 惠王 鵬 惠王 鵬 惠 結果 9.5% with postoperative adjuvant therapy

13. 王 鵬 惠王 鵬 惠王 鵬 惠王 鵬 惠 Although vaginal hysterectomy is not considered the current standard surgical treatment for endometrial cancer, we agree with others in the selective use of this route for the surgical management of endometrial carcinoma.Although vaginal hysterectomy is not considered the current standard surgical treatment for endometrial cancer, we agree with others in the selective use of this route for the surgical management of endometrial carcinoma. The decision to proceed with vaginal hysterectomy should be made after careful evaluation of each individual patient with regard to age, weight, medical comorbidities, anatomy, patient preference, presumed grade and stage of tumor, quality of life, and in some cases adjuvant studies such as radiologic imaging.The decision to proceed with vaginal hysterectomy should be made after careful evaluation of each individual patient with regard to age, weight, medical comorbidities, anatomy, patient preference, presumed grade and stage of tumor, quality of life, and in some cases adjuvant studies such as radiologic imaging. AJOG 2007;197:202e1-202e7. 討論

14. 王 鵬 惠王 鵬 惠王 鵬 惠王 鵬 惠 An informed discussion with the patient and consultation with a gynecologic oncologist regarding this nontraditional approach are important.An informed discussion with the patient and consultation with a gynecologic oncologist regarding this nontraditional approach are important. Vaginal hysterectomy may have an increased role in the treatment of endometrial cancer as the population continues to age and has increasing rates of obesity and coexisting medical comorbidities.Vaginal hysterectomy may have an increased role in the treatment of endometrial cancer as the population continues to age and has increasing rates of obesity and coexisting medical comorbidities. AJOG 2007;197:202e1-202e7. 討論

15. THE END Thanks for your attendance and your attention