新辅助化疗后经腹与腹腔镜宫颈癌根治术围手术期并发症与安全性评价  

Perioperative complications and safety evaluation of abdominal and laparoscopic radical hysterectomy of cervical carcinoma after neoadjuvant chemotherapy

作　　者：张晓玉 周琦[1] ZHANG Xiaoyu;ZHOU Qi(Department of Gynecology,Affiliated Tumor Hospital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学附属肿瘤医院妇外四科,乌鲁木齐830011

出　　处：《新疆医科大学学报》2018年第1期35-38,共4页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金(2015211C130)

摘　　要：目的评价新辅助化疗后经腹与腹腔镜2种宫颈癌根治术在围手术期的并发症与安全性。方法回顾性分析2010年1月1日-2015年12月31日在新疆医科大学附属肿瘤医院收治的ⅠB2期、ⅡA2期共计137例宫颈癌患者的临床资料,其中54例患者行经腹宫颈癌根治术(经腹组,ARH组),83例患者行腹腔镜下宫颈癌根治术(腹腔镜组,LRH组),比较2组患者术前及术中各项指标的变化,并对2组术后并发症及化疗安全性进行评价。结果 ARH组与LRH组在化疗方案、疗程以及化疗毒副作用方面差异无统计学意义(P>0.05)。LRH组患者术中出血量及术中输血例数少于ARH组,LRH组患者术中切除淋巴结个数多于ARH组(P<0.05)。LRH组肛门排气时间、术后住院时间以及总住院时间均短于ARH组(P<0.05)。结论腹腔镜手术方式具有术中出血少、创伤小、术后恢复快、住院时间短的优势,对局部晚期宫颈癌患者而言,NACT后行腹腔镜手术优于NACT后经腹手术方式,值得临床推广。Objective To evaluate perioperative complications and safety of abdominal and laparoscopic radical hysterectomy of cervical carcinoma after neoadjuvant chemotherapy.Methods A retrospective analysis was on clinical data of total of137cases of cervical cancer patients in the periods of IB2and IIA2in the Affiliated Tumor Hospital of Xinjiang Medical University during January1,2010-December31,2015,in which54patients were undergone abdominal radical hysterectomy(abdominal group,ARH group)and83patients were undergone laparoscopic radical resection of cervical cancer(laparoscopic group,LRH group).The changes before surgery and intraoperative indexes of the2groups patients were compared,and postoperative complications and safety of chemotherapy of the2groups were evaluated.Results There were no significant differences in chemotherapeutic protocol,course of treatment and side effects between the ARH group and the LRH group(P>0.05).Intraoperative bleeding and postoperative blood transfusion cases in the LRH group were less than that in the ARH group,and the number of resected lymph node during the surgery in the LRH group was more than that in the ARH group(P<0.05).And anal exhaust time,the postoperative hospitalization time and total hospitalization time of the LRH group were shorter than that of the ARH group(P<0.05).Conclusion Laparoscopic surgery showed advantages of less intraoperative bleeding,less trauma,faster postoperative recovery and shorter hospitalization time.Considering locally advanced cervical cancer patients,laparoscopic surgery after NACT is better than NACT after abdominal operation,which is worth promoting in clinical.

关 键 词：宫颈癌 新辅助化疗 手术 并发症 安全性 

分 类 号：R737.33[医药卫生—肿瘤]