腹腔镜下广泛性全子宫切除术治疗早期宫颈癌的疗效观察  

Efficacy of laparoscopic radical hysterectomy for early-stage cervical carcinoma

作　　者：蒋镌[1] 毛世琴[1] 史淑兰[1] 陈国英[1] 

机构地区：[1]江苏省靖江市人民医院妇科,靖江214500

出　　处：《中国肿瘤临床与康复》2016年第9期1091-1094,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨腹腔镜下广泛性全子宫切除术治疗早期宫颈癌的近远期疗效。方法回顾性分析2011年1月至2012年1月在靖江市人民医院接受手术治疗的70例早期宫颈癌患者的临床病历资料。按照手术方式的不同,将患者分为观察组和对照组,每组35例。对照组患者采用常规开腹子宫切除和淋巴结清扫,观察组患者采用腹腔镜辅助下广泛性全子宫切除手术和淋巴结清扫。随访3年,比较两组患者手术中及手术后相关指标、并发症情况和1~3年生存率。结果观察组患者的手术时间明显长于对照组,而手术中出血量和手术中输血量均明显少于对照组,差异均有统计学意义（均P〈0.05）。观察组患者盆腔引流量、肛门排气时间、体温恢复至正常时间、尿管拔除时间、静脉使用抗生素时间和住院时间均少于对照组,差异均有统计学意义（均P〈0.05）。观察组患者手术后并发症发生率为8.6%,明显少于对照组的28.6%,差异有统计学意义（P〈0.05）。观察组患者手术后1~3年生存率与对照组比较,差异均无统计学意义（均P〉0.05）。结论腹腔镜辅助下广泛性全子宫切除术治疗早期宫颈器患者可获得较好的近远期疗效,且安全性较好,值得临床推广应用。Objective To assess near and long-term effectiveness of laparoscopic radical hysterectomy for early-stage cervical carcinoma. Methods Retrospective analysis of clinical data of 70 patients with early cervical cancer treated in Jingjiang People＇s Hospital from January 2011 to January 2012. According to surgical patterns,patients were divided into observation group and control group with 35 patients in each group. Patients in the control group received routine abdominal hysterectomy and lymph node dissection; patients in the observation group received laparoscopic hysterectomy and lymph node dissection. All patients were followed up for 3 years. Relevant index during and after surgery,incidence of postoperative complications and 1-3 year survival rate were compared between two groups. Results The operation time in the observation group was significantly longer than the control group,and the intraoperative bleeding and transfusion volume in surgery were significantly less than the control group,with a statistically significant difference（ P〈0. 05）. Pelvic drainage volume,flatus time,and time of body temperature back to normal,extubation,intravenous antibiotic use and hospital stay in the observation group were less than the control group,with a statistically significant difference（ P〈0. 05）. Incidence of postoperative complications was 8. 6% in the observation group which was significantly less than 28. 6% of the control group,with a statistically significant difference（ P〈0. 05）. There was no significant difference in the survival rate between two groups after 1-3 years（ P〉0. 05）. Conclusion laparoscopic radical hysterectomy for patients with early-stage cervical carcinoma is safe and can provide long-term benefits. Thus,it is worthy of wide application in clinical practice.

关 键 词：子宫肿瘤 腹腔镜 广泛性全子宫切除术 淋巴结清扫 治疗结果 

分 类 号：R737.33[医药卫生—肿瘤]