新辅助化疗后机器人辅助与开腹手术治疗局部晚期子宫颈癌术后生存影响因素的对比分析  

Comparative analysis of the influencing factors on postoperative survival between robotic surgery and conventional laparotomy for locally advanced cervical cancer after neoadjuvant chemotherapy

作　　者：周潇妮 唐旭秀 蔡丽萍[3] 涂春华[3] 张智[3] 张琦玲 肖子文 赵娜 ZHOU Xiaoni;TANG Xuxiu;CAI Liping;TU Chunhua;ZHANG Zhi;ZHANG Qiling;XIAO Ziwen;ZHAO Na(Department of Gynecology,the Second People’s Hospital of Jingdezhen,Jingdezhen 333000,China;The First Clinical Medical College of Nanchang University,Nanchang 330000,China;Department of Obstetrics and Gynecology,the First Affiliated Hospital of Nanchang University,Nanchang 330000,China;Department of Clinical Laboratory,the Second People’s Hospital of Jingdezhen,Jingdezhen 333000,China)

机构地区：[1]景德镇市第二人民医院妇科,江西景德镇333000 [2]南昌大学第一临床医学院,江西南昌330000 [3]南昌大学第一附属医院妇产科,江西南昌330000 [4]景德镇市第二人民医院检验科,江西景德镇333000

出　　处：《机器人外科学杂志（中英文）》2024年第2期178-185,共8页Chinese Journal of Robotic Surgery

基　　金：江西省自然科学基金(20192ACBL20038);江西省科技计划重大项目(20152ACG70022)。

摘　　要：目的:探究局部晚期宫颈癌患者在新辅助化疗后应用机器人辅助下腹腔镜手术与开腹手术治疗后术后生存质量的差异,并对其影响因素进行分析。方法:对2016年1月—2016年12月在南昌大学第一附属医院妇科接受治疗的76例宫颈癌患者进行回顾性研究。其中研究组为机器人手术组,38例患者全部于新辅助化疗结束后行机器人辅助腹腔镜下广泛性子宫切除术及盆腔淋巴结清扫术;对照组为开腹手术组,38例患者在新辅助化疗结束后行开腹下广泛性子宫切除术及盆腔淋巴结清扫术;两组均对部分患者行腹主动脉旁淋巴结取样。纳入研究对象的一般临床特征、术后手术质量评价指标并统计和分析其无进展生存期及总生存期。结果:研究组与对照组的一般临床特征无差异,但研究组术后多项手术质量评价指标与对照组均有统计学差异(P<0.05)。两组病理预后因素、无病生存期、总生存期、3年生存率和5年生存率比较,差异无统计学意义(P>0.05);经单因素和多因素Cox比例风险模型分析发现,宫颈浸润程度和术后是否补充放化疗为预后独立危险因素。结论:对于局部晚期宫颈癌患者,机器人辅助腹腔镜手术比传统开腹手术的手术质量评价好,但两者在患者病理预后因素及术后生存期上无明显差异。Objective:To explore the differences of postoperative survival between patients underwent robot-assisted laparoscopic surgery and conventional laparotomy for locally advanced cervical cancer after neoadjuvant chemotherapy.Methods:A retrospective study was performed on 76 patients with cervical cancer who were treated in the Department of Gynecology,the First Affiliated Hospital of Nanchang University from January 2016 to December 2016.Among which,38 patients underwent robot-assisted laparoscopic radical hysterectomy and pelvic lymph node dissection after neoadjuvant chemotherapy were divided into the study group,and 38 patients who were treated with conventional laparotomy after neoadjuvant chemotherapy into the control group.There was part of patients underwent para-aortic lymph node sampling in both groups.Results:There was no difference in terms of the general clinical characteristics between the two groups,but significant differences on surgical quality evaluation indicators were found between the two groups(P<0.05).There was no significant difference in pathological prognostic factors,disease-free survival,overall survival,3-year survival rate,and 5-year survival rate(P>0.05).Doing chemoradiotherapy or not after surgery was an independent prognostic risk factor.Conclusion:For patients with locally advanced cervical cancer,robotassisted surgery has better evaluation of surgical quality after surgery than the conventional laparotomy,but no significant difference was found in terms of pathological prognostic factors and postoperative survival between the two ways.

关 键 词：子宫颈癌 机器人辅助手术 开腹手术 总生存期 无病生存期 

分 类 号：R608[医药卫生—外科学] R713.4[医药卫生—临床医学]