摘要
目的探讨后装联合腹腔镜下广泛性子宫切除术(LRH)加盆腔淋巴结清扫术治疗Ⅰb2、Ⅱa2宫颈癌的可行性。方法我院自2011年1月至2014年5月间收治的Ⅰb2、Ⅱa2宫颈癌病人共80例,随机分为两组,后装放疗后行腹腔镜下广泛性子宫切除加盆腔淋巴结清扫术治疗40例作为研究组,随机选择同期别宫颈癌行腹腔镜下广泛性子宫切除术加盆腔淋巴结清扫术40例作为对照组,对两组术中、术后和生存情况进行比较。结果手术平均时间:研究组(178.5±14.5)min,对照组(284.8±48.6)min,P<0.05。术中出血量:研究组(62.5±51.3)ml,对照组(237.8±172.7)ml,P<0.05。两组术中无并发症发生,无中转开腹。术后并发症的发生率:研究组2.5%(1/40),对照组52.5%(21/40),P<0.001。复发情况:研究组3年内无复发,3年存活率100.0%;对照组3年内复发9例,复发率为22.5%(9/40),P<0.05。结论后装放疗后腹腔镜下广泛性子宫切除加盆腔淋巴结清扫术治疗Ⅰb2、Ⅱa2期宫颈癌是可行的,并且在缩短手术时间、减少术中出血量、降低术后并发症、降低术后复发率等方面有明显优势,值得多中心、前瞻性、随机性对照临床研究,确定后装放疗后行腹腔镜下广泛性子宫切除加盆腔淋巴结清扫术治疗Ⅰb2、Ⅱa2宫颈癌的临床价值。
Objective To explore the feasⅠbility of post-dressing treatment combined with extensive laparoscopic hysterectomy and pelvic lymphadenectomy for the treatment ofⅠb2 andⅡa2 cervical cancer.Methods During January 2011 to May 2014,80 patients withⅠb2,Ⅱa2 cervical cancer were recruited and were randomly divided into two groups.The experimental group(40 patients)was treated with post-dressing treatment combined with extensive laparoscopic hysterectomy and pelvic lymphadenectomy.The control group(40 patients)was only treat with laparoscopic hysterectomy and pelvic lymphadenectomy.The operative and postoperative conditions were compared.Results The mean time of operation was(178.5±14.5)min in the study group and(284.8±48.6)min in the control group,P<0.05.The average blood loss was(62.5±51.3)ml in the study group and(237.8±172.7)ml in the control group,P<0.05.There was no complication in the two groups.The incidence of postoperative complications was 2.5%(1/40)in the study group and 52.5%(21/40)in the control group,P<0.001.The was no relapse,and the 3-year survival rate was 100%in the study group;In the control group,9 cases had recurrence in 3 years(22.5%,9/40),3-year survival rate was 97.5%.Conclusion Post-dressing treatment combined with extensive laparoscopic hysterectomy and pelvic lymphadenectomyas a treatment to cervical cancer inⅠb2 andⅡa2 is feasible.The operation time was shorten with less intraoperative blood loss,and intraoperative complications,postoperative recurrence,metastasis were reduced compared with control group.To further evaluation to the clinical value of post-dressing treatment combined with extensive laparoscopic hysterectomy and pelvic lymphadenectomy for the treatment ofⅠb2 andⅡa2 cervical cancer,it is worth to more central,prospective,randomized controlled clinical studies.
作者
庄甲花
ZHUANG Jia-hua(Linyi City Tumour Hospital,Linyi 276001,China)
出处
《山东医学高等专科学校学报》
2018年第1期21-25,共5页
Journal of Shandong Medical College
基金
临沂市科技发展计划项目(201717053)
关键词
宫颈癌
后装放疗
腹腔镜
Cervical cancer
Post-dressing treatment
Laparoscopy
