淋巴显影联合腹腔镜下盆腔淋巴结切除在早期宫颈癌治疗中应用探讨  

Application of lymphoscintigraphy and laparoscopic pelvic lymph node dissection in the treatment of early stage cervical cancer

作　　者：方英[1] 余晓[1] 夏利花[1] 徐小敏[1] 周燕[1] 

机构地区：[1]浙江中医药大学附属衢州中心医院妇科,浙江衢州324000

出　　处：《中国内镜杂志》2013年第8期845-847,共3页China Journal of Endoscopy

摘　　要：目的探讨淋巴显影联合腹腔镜下盆腔淋巴结切除在早期宫颈癌治疗中的应用价值。方法选取诊断明确的早期宫颈癌患者54例设为研究组,使用亚甲蓝淋巴显影后行腹腔镜下广泛子宫切除术和盆腔淋巴结清扫术。另选48例未经淋巴显影直接行腹腔镜下宫颈癌根治术的早期宫颈癌患者设为对照组,将两组患者的手术时间、术中出血量、切除的PLN数、术中术后并发症、住院时间等资料进行比较分析。结果手术时间研究组较对照组明显增加,差异有显著性(t=5.58,P<0.01);术中出血量研究组较对照组明显减少,差异有显著性(t=4.32,P<0.01);切除的PLN数研究组较对照组明显增多,差异有显著性(t=2.67,P<0.01);术中术后并发症例数及住院时间研究组较对照组均有减少趋势,但差异无显著性(χ2=0.40、t=0.67,P>0.05)。结论淋巴显影联合腹腔镜下盆腔淋巴结切除可有效增加PLN的识别度,降低淋巴清扫的难度,提高手术的精确度,减少术中出血及并发症发生率,在早期宫颈癌治疗中具有较高的临床价值。【Objective】To explore the value of lymphoscintigraphy and laparoscopic pelvic lymph node dissection in the treatment of early stage cervical cancer.【Methods】54 patients with early cervical cancer patients were assigned to the study group,laparoscopic radical hysterectomy and pelvic lymph node dissection after methylene blue lymphoscintigraphy.In addition,48 patients with early cervical cancer patients were used as control group,they direct laparoscopic radical hysterectomy without lymphoscintigraphy.Analysis and comparison of two groups of patients,operative time,blood loss;number of PLN resection,intraoperative and postoperative complications,length of stay and other information.【Results】Operative time in study group increased significantly compared with the control group,the difference was significant（t =5.58,P 0.01）;blood loss in study group was significantly reduced compared with the control group,the difference was significant（t =4.32,P 0.01）;the resection PLN in study group than the control group increased significantly,the difference was significant（t =2.67,P 0.01）;the number of cases of intraoperative and postoperative complications and length of stay in study group compared with the control group there was a decline,but the difference was not statistically significant（χ2=0.40,t =0.67,P 0.05）.【Conclusion】 Lymphography and laparoscopic pelvic lymph node dissection can effectively increase the degree of recognition of the PLN,reduce the difficulty of dissection,improve the accuracy of the surgery to reduce blood loss and the incidence of complications,so it has a high clinical value in the treatment of early stage cervical cancer.

关 键 词：宫颈癌 淋巴显影 腹腔镜 亚甲蓝 

分 类 号：R737.33[医药卫生—肿瘤]