广泛性子宫颈切除手术途径之探讨  

Study on the surgical approach to radical trachelectomy

作　　者：鲁琦[1] 刘崇东[1] LU Qi;LIU Chong-dong(Department of Ob?stetrics and Gynecology,Beijing Chao-yang Hospital Affiliated to Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院妇产科,北京100020

出　　处：《中国实用妇科与产科杂志》2020年第4期325-328,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：北京市医院管理局临床医学发展专项经费资助扬帆计划妇科肿瘤手术治疗学(ZYLX201712)。

摘　　要：广泛性子宫颈切除术(radical trachelectomy,RT)是一种可以保留患者生育能力的治疗早期子子宫颈癌的手术方式,该手术可以通过阴道、开腹或者腹腔镜来完成,但不同的手术途径适应证不同,对患者的肿瘤预后以及生育结局的影响不尽相同。对于早期子宫颈癌肿瘤直径<2 cm的患者,3种手术途径具有相同的肿瘤预后,但是经阴道及腹腔镜子宫颈广泛切除的妊娠率明显高于开腹术后的妊娠率。对于肿瘤直径2~4 cm的患者,可以直接进行开腹子宫颈广泛切除,或者选择进行新辅助化疗待肿瘤直径缩小后进行经阴道或者腹腔镜子宫颈广泛切除同样也是安全有效的。Radical trachelectomy is a surgical method that can preserve the fertility of patients in the treatment of early cervical cancer,which can be performed by vagina,laparotomy or laparoscopy,but different surgical approaches have different indications and have different effects on tumor prognosis and fertility outcome.For patients with early stage cervical cancer whose tumor diameter is <2 cm,the three surgical approaches have the same tumor prognosis.However,the pregnancy rate of LVRT and LRT is significantly higher than that of ART.For patients whose tumor diameter is 2-4 cm,ART or NACT followed by LVRT or LRT is also safe and effective,when the diameter is reduced by neoadjuvant chemotherapy.

关 键 词：子宫颈肿瘤 广泛性子宫颈切除术 经阴道 开腹 腹腔镜 

分 类 号：R737.3[医药卫生—肿瘤]