腹腔镜下宫颈癌根治术治疗新辅助动脉化疗后巨块型宫颈癌的疗效  

Curative effect of laparoscopic radical hysterectomy in treatment of bulky cervical cancer after neoadjuvant intra-arterial chemotherapy

作　　者：杨惠芬 朱雪琼[2] 

机构地区：[1]温州医科大学附属第五医院,浙江丽水323000 [2]温州医科大学附属第二医院,浙江温州325000

出　　处：《中国妇幼保健》2017年第18期4540-4543,共4页Maternal and Child Health Care of China

基　　金：浙江省医药卫生科技计划项目(2013ZDA016)

摘　　要：目的观察腹腔镜下宫颈癌根治术(LRH)与传统经腹宫颈癌根治术(ARH)治疗经新辅助动脉化疗(NAIC)后巨块型宫颈癌患者的临床评价指标,并探讨其可行性、安全性、近期疗效及临床应用价值。方法选取2012年1月-2016年6月在温州医科大学附属第五医院就诊的42例NAIC后巨块型宫颈癌患者为研究对象,根据手术方式分为LRH组18例,ARH组24例,比较两组患者的手术时间、手术出血量、清扫淋巴结数目、肛门排气时间、住院时间以及并发症(切口脂肪液化或感染、膀胱输尿管损伤、肠道损伤、尿潴留、深静脉血栓、淋巴囊肿、淋巴水肿、下肢疼痛或麻木等)的差异情况。结果两组手术时间、清扫淋巴结数目比较,差异无统计学意义(P>0.05);但LRH组手术出血量、肛门排气时间、住院时间明显少于ARH组(P<0.05)。LRH组切口脂肪液化或感染率、淋巴囊肿发生率低于ARH组(P<0.05);两组其他术后并发症发生率比较,差异无统计学意义(P>0.05)。结论 LRH组具有微创、手术出血少、术后恢复快、相关并发症少及住院时间短等明显优势,对NAIC后巨块型宫颈癌的手术近期疗效具有显著的优越性和重要的临床应用价值。Objective To observe the clinical evaluation indexes of laparoscopic radical hysterectomy （LRH） and traditional abdomi- nal radical hysterectomy （ARH） in treatment of bulky cervical cancer after neoadjuvant intra-arterial chemotherapy, explore the feasibility, safety, short-term curative effect, and clinical application value of the two operation methods. Methods Forty-two bulky cervical cancer patients after neoadjuvant intra-arterial chemotherapy were selected from the hospital from January 2012 to June 2016, then they were divided into LRH group （18 patients） and ARH group （24 patients） according to operation methods. Operation time, the amount of blood loss during operation, the numl^er of excised lymph nodes, ahal exhausing time, the hospitalization time, and incidence rates of complications （ fat liquefaction or infection of incisional wound, bladder and catheter injury, intestinal injury, urinary retention, deep venous thrombosis, lymphocele, lymphedema, ache or numbness of lower limb） in the two groups were compared. Results There was no statistically significant difference in operation time and the number of excised lymph nodes between the two groups （P〉0. 05 ） . The amount of blood loss during operation, anal exhausing time, and the hospitalization time in LRH group were statistically significantly lower than those in ARH group （P〈 0. 05 ） . The incidence rates of fat liquefaction or infection of incisional wound and lymphocele in LRH group were statistically significantly lower than those in ARH group （P〈0. 05） . There was no statistically significant difference in the incidence rates of other postoperative complications between the two groups （P〉O. 05） . Conclusion LRH has the advantages of less trauma, less bleeding, faster recovery, fewer complications, and shorter hospitalization time compared with ARH. The short-term curative effect of LRH in treatment of bulky cervical cancer after neoadjuvant intra-arterial chemotherapy is significant, and the clinical

关 键 词：腹腔镜手术 开腹宫颈癌根治术 新辅助动脉化疗 巨块型宫颈癌 

分 类 号：R737.33[医药卫生—肿瘤]