摘要
目的探讨阴式广泛性宫颈切除术(vaginal radical trachelectomy,VRT)对宫颈癌患者复发和生育的影响。方法回顾性分析208例早期宫颈癌患者资料,有195例患者成功接受VRT手术,且均保留了生育功能;记录195例患者的手术指标、复发情况和生育情况,并进行随访。结果手术平均时间为(179.56±37.17)min,术中出血量为(325.79±127.54)ml,术中切除淋巴结的数目为(24.47±9.83)枚,切除宫颈的长度为(2.63±0.68)cm;出现术中并发症者有4例,出现术后并发症者8例;术后总复发率为12.31%(24/195),复发部位以宫旁最多见(66.67%,16/24);171例鳞癌患者中共有12例(7.02%)复发,16例腺癌患者和8例腺鳞癌患者中共有12例(50.00%)复发,复发率的差异具有统计学意义(P<0.05);肿瘤>2 cm的32例患者中有13例(40.63%)复发,肿瘤≤2 cm的163例患者中有11例(6.75%)复发,差异具有统计学意义(P<0.05);141例患者具有妊娠的意愿,其中有55例生育,生育率为39.01%;肿瘤直径≤2 cm的患者与>2cm的患者之间的生育率差异无统计学意义(P>0.05)。结论 VRT在保留患者的生育功能方面是比较成熟的,肿瘤直径大于2 cm是患者术后复发的危险因素。
Objective To investigate the recurrence rate and fertility outcomes of cervical cancer patients treated with vaginal radical trachelectomy （VRT）. Method A retrospective analysis was conducted in 208 cases with early stage cervical cancer, in which 195 cases had successful VRT with fertility preserved, and were followed up and their surgery parameters, recurrence and fertility outcomes were documented. Result The average operative time was （179.56 ± 37.17） min, the bleeding volume was （325.79 ± 127.54） ml, number of resected lymph nodes was （24.47 ± 9.83）, length of resected uterine cervix was （2.63 ± 0.68） cm; intra-operative complications occurred in 4 cases, while 8 cases had postoperative complications; the total recurrence rate was 12.31% （24/195）, the site with the highest re-currence was parametrium （66.67%, 16/24）; Twelve （7.02%,） cases in 171 squamous patients experienced recurrence, and there were 12 （50.0%, 12/24） relapsed cases in 16 adenocarcinoma and 8 adenosquamous carcinoma patients, and＆amp;nbsp;the difference of recurrence rate regarding tumor type was statistically significant （P 〈 0.05）. Thirteen patients in 32 cases with tumor size 〉2 cm had recurrence （40.63%）, of the 163 cases of patients with tumor ≤2 cm, there were 11 recurrence cases （6.75%）, which was significantly less （P 〈 0.05）; Of the 141 patients who had intention of pregnan-cy, 55 （39.01%） became pregnant; No statistically significant difference was observed between patients with tumor 〉2 cm and ≤2 cm （P 〉 0.05）. Conclusion VRT is a mature surgical modality in respect of preserving fertility of pa-tients, and tumor diameter greater than 2 cm is a risk factor of postoperative recurrence in patients with cervical can-cer.
出处
《癌症进展》
2015年第3期342-345,共4页
Oncology Progress
