妇科肿瘤全量放射治疗后手术82例回顾分析  

Retrospective Analysis of Surgery Following Radical Irradiation for 82 Cases with Gynecologic Cancer

作　　者：白萍[1] 李晓江[1] 俞高志[1] 高菊珍[1] 章文华[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院,北京100021

出　　处：《肿瘤学杂志》2006年第5期366-369,共4页Journal of Chinese Oncology

摘　　要：[目的]分析宫颈癌及子宫内膜癌全量放射治疗后再手术的临床情况。[方法]回顾71例宫颈癌及11例子宫内膜癌行全量体外+腔内放疗,因各种指征行筋膜外子宫切除术57例、附件切除术9例,次广泛或广泛子宫切除术10例等。[结果]手术时间:筋膜外子宫切除术平均2.7h,次广泛或广泛子宫切除术3.8h,附件切除术1.8h。手术出血量:39例<200ml,30例≥200ml(平均462m1)。手术并发症包括:伤口裂开3例,伤口感染3例,泌尿道并发症4例,肠瘘1例,肠损伤1例,总并发症14.7%,术后病理显示宫颈残存癌或肿瘤复发、转移/宫体受侵39例,5年生存率44.3%;子宫内膜癌未控或新发生的子宫内膜癌16例,5年生存率64.5%。[结论]全量放射治疗后再手术并发症相对增多,但筋膜外子宫切除术仍是安全、有效的治疗方法。[Purpose] To investigate the clinieal outcome of the cervical and endometrM carcinomas treated with surgery following whole dose irradiation therapy. [Methods] Seventy-one cases with cervical carcinoma and 11 eases with endometrial carcinoma were managed initially by radical radiotherapy. Surgery was performed for recurrent or persistent disease, including extrafascial hysterectomy in 57 cases, salpingo-oophreetomy in 9 cases and radical hystereetomy or modified radical hysterectomy in 10 cases. [Results] The mean operation time was 2.7 hours in extrafaseial bystereetomy group, 3.8 hours in radical or modified group, and 1.8 hours in salpingo-oophreetomy group. Surgical blood loss was 〈200ml in 39 eases,≥200ml in 30 cases with mean 462ml. The overall surgical complications was 14.7%, including wound dehiscence in 3 cases, wound infect in 3 eases, urinary complications in 4 case, bowel fistula in 1 case, and bowel injury in 1 case. Surgical specimens in 39 cases pathologically revealed cervical residual cancer or recurrences. The 5-year survival of these 39 cases was 44.3%. The 5-year survival was 64.5% in 16 cases with persistent disease or new diagnosed endometrial carcinoma. [Conclusion] Surgical complications relatively increase after whole （lose radiotherapy, however the extrafaseial hysterectomy is still the treatment modality with effect and safety.

关 键 词：宫颈肿瘤 子宫内膜肿瘤 放射疗法 并发症 外科学 

分 类 号：R737.3[医药卫生—肿瘤]