放疗前腹腔镜下卵巢移位术在年轻中晚期宫颈鳞癌患者中应用的临床研究  

Laparoscopic Ovarian Transposition before Pelvic Irradiation in Patients Treated for Medium-Term and Advanced Cervical Squamous Cell Carcinoma

作　　者：倪镌[1] 寿华锋[1] 朱滔[1] 陈仲波[1] 陈雅卿[1] 

机构地区：[1]浙江省肿瘤医院妇瘤科,杭州310022

出　　处：《医学研究杂志》2014年第6期89-92,共4页Journal of Medical Research

基　　金：浙江省医药卫生科学研究基金资助项目(2009B027)

摘　　要：目的 为更好地满足肿瘤患者治疗后对生活质量的要求,对年轻中晚期宫颈鳞癌患者放疗前行腹腔镜下卵巢移位术的安全性、有效性进行研究.方法 对27例45岁以下ⅡB～ⅢB期宫颈鳞癌患者在放疗前实行腹腔镜下卵巢移位术,术后恢复日常活动即开始放化疗.治疗后监测患者围绝经期症状情况,卵巢激素情况及肿瘤情况.结果 27例患者均无发生严重的术中、术后并发症,术后开始放化疗时间平均4.9（3 ～8）天.治疗后在对最终入组的26例实验对象定期随访中,18例（69.2％）患者未出现FSH的升高,另外8例（30.8％）患者出现了FSH的升高,其中5例年龄＞40岁患者中4例出现了FSH的升高.随访期间无病例发生卵巢转移.结论 年轻中晚期宫颈鳞癌患者,特别是年龄＜ 40岁的患者,放疗前行腹腔镜下卵巢移位术是安全、有效的,其可能为临床保留卵巢功能、提高患者生活质量开辟新的思路.Objective To improve the quality of life of patients, this study was to discuss the feasibility and safety of laparoscopic ovarian transposition before pelvic irradiation in young patients with medium - term and advanced cervical squamous cell carcinoma. Methods Twenty seven premenopausal patients who treated for ⅡB～ⅢB stage cervical squamous cell carcinoma experienced with laparoscopie ovarian transposition. After preservation of ovarian function, patients＇ symptoms and serum follicle - stimulating hormone level were assessed. Results Laparoscopic ovarian transposition was performed in 27 patients. No immediate intraoperative or postoperative complications were observed. The mean duration of hospitalization was 4.9 days （ range 3 - 8 days）. One patient was lost to follow - up. Ovarian preservation was achieved in 18 （69.2%） of 26 patients. The four patients experienced ovarian failure in all five ones over 40 years. No patient was detected ovarian metastasis at follow - up. Conclusion Laparoscopie ovarian transposition is a safe and effective procedure for preserving ovarian function. This procedure should be considered in premenopausal women, especially for those less than 40 years old, who need to undergo pelvic irradiation for cervical squamous cell carcinoma.

关 键 词：卵巢移位 宫颈鳞癌 盆腔放疗 腹腔镜 

分 类 号：R737[医药卫生—肿瘤]