腹腔镜下宫颈癌根治术治疗宫颈癌的临床分析  

Clinical Analysis of Laparoscopic Radical Hysterectomy for Cervical Cancer

作　　者：马原[1] 魏向群[1] 杨琳琳[1] 谭树芬[1] 高扬[1] 刘熙[1] 冯雨[2] 

机构地区：[1]昆明医科大学第三附属医院妇瘤科,云南昆明650118 [2]昆明医科大学第三附属医院,云南昆明650118

出　　处：《昆明医科大学学报》2013年第10期107-110,115,共5页Journal of Kunming Medical University

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目(2010DC182)

摘　　要：目的：探讨腹腔镜下宫颈癌根治术（laparoscopic radical hysterectomy，LRH）加盆腔淋巴结清扫术治疗宫颈癌的可行性、安全性及临床推广价值．方法收集2009年6月至2013年6月昆明医科大学第三附属医院妇瘤科收治的80例LRH组患者的临床资料，分析LRH在昆明医科大学第三附属医院妇瘤科的开展情况及其学习曲线．选取40例于2012年6月至2013年6月期间行传统经腹宫颈癌根治术（abdominal radical hysterectomy， ARH）加盆腔淋巴结清扫术的患者作为对照组，并在同时期2组间进行相关指标对比分析．结果按LRH开展时期先后以40例为界限分为A、B 2组，与A组相比，B组手术时间缩短约26.9%，术中出血量减少约37.3%，淋巴结清除量增加约37.2%，术中并发症降低约7.5%，住院时间平均减少约2.2 d，住院总费用有所减少但无显著性差异（＞0.05）．LRH的学习曲线约40例左右．2012年6月至2013年6月同时期LRH组患者在多项指标上均优于ARH组．术后随访2～48个月，ARH组1例复发，LRH组未见复发病例．结论 LRH在昆明医科大学第三附属医开展情况良好且安全可行，并以其手术创伤小、患者痛苦少、术后恢复快、手术瘢痕小、符合美学要求等优点，具有广阔的临床应用前景并值得向临床推广普及．Objective To study the feasibility, safety and clinical application value of LRH, comparing with abdominal radical hysterectomy （ARH） . Methods A total of 80 patients＇ clinical data were collected to analyze the development of LRH in Yunnan Tumor Hospital while compared with another 40 patients between June 2012 to June 2013 of ARH for some associative indexes. Results The patients were divided into group A and B equally.Compared with Grope A, the time of operation decreased 26.9%, 37.2% has been augment for lymph gland sweeping, the amount of bleeding and intraoperative complication reduced 37.3% and 7.5% in Grope D, respectively, with distinctive difference （ 〉0.05） .Hospitalization expenses had a small degree reduced but no distinctive difference.The learning curve of LRH was 40 approximately.Comparison between LRH and ARH in the same period showed that LRH was more splendid than ARH in several index.1 case relapsed in 2-48 months follow-up in ARH while no relapse in the other group. Conclusion LRH is safe and feasible and has good prospects in clinical application and deserves clinical generalization because of its advantages such as less trauma,less pains, quick recovery,less scars and aesthetical appearance.

关 键 词：微创外科 腹腔镜 宫颈癌根治术 学习曲线 

分 类 号：R737.33[医药卫生—肿瘤]