摘要
目的对比分析腹膜外/经腹膜淋巴结切除分期术在中晚期宫颈癌中的应用。方法选取江西省妇幼保健院肿瘤科首诊伴淋巴结肿大的中晚期宫颈癌(ⅡB-IVA期)40例,按照手术方式随机分成腹膜外组(n=20)和经腹膜组(n=20),分别行腹膜外及经腹膜盆腔淋巴结和腹主动脉旁淋巴结切除分期术,术后行同步放化疗。结果腹膜外组和经腹膜组均完成盆腔淋巴结和腹主动脉旁淋巴结切除,腹膜外组的手术时间短,术中出血少,术后排气时间快,术后至放疗开始时间短,分别为:119.45±10.12vs141.15±8.03min,51.50±7.63vs71.50±10.01ml,26.0±2.87vs52.65±11.52h,9.00±0.92vs12.35±1.76d,且术中血压平稳,肠粘连肠梗阻及淋巴囊肿术后并发症少,随访放射性肠炎轻,跟经腹膜组差异有统计学意义(均P<0.05),淋巴结切除个数41.20±2.95vs42.10±4.68个P>0.05,差异无统计学意义,尚不能改善患者预后。结论虽不能改善患者预后,但伴淋巴结肿大的中晚期宫颈癌腹膜外淋巴结切除分期术较经腹膜入路更具优势,提高了患者生活质量,值得推荐。
Objective The aim of this study was to compare the efficiency of two different lymphadenectomy method(extraperitoneal or transabdominal preperitoneal)in locally advanced cervical cancer(LACC).Methods 40 LACC patients with enlarged lymph node initially treated in our hospital were included in this study.All patients underwent extraperitoneal lymphadenectomy(n=20)or transabdominal preperitoneal lymphadenectomy(n=20)prior concurrent chemo-radiation therapy(CCRT).Results Patients in both group completed lymphadenectomy successfully,while the operational time,estimated blood loss,postoperative intestinal exhaust and radiotherapy start time in the extraperitoneal group were all superior to the transabdominal preperitoneal group.They were 119.45±10.12 min Vs.141.15±8.03 min,51.50±7.63 ml Vs.71.50±10.01 ml,26.0±2.87 h Vs.52.65±11.52 h and 9.00±0.92 d vs.12.35±1.76 d.Furthermore,the incidence of intestinal adhesion,intestinal obstruction,lymphcyst and?radiation proctitis in the extraperitoneal group were less than that of transabdominal preperitoneal group(all P<0.05).The average number of resected lymph nodes of two groups were 41.20±2.95 and 42.10±4.68,respectively(P>0.05).The survival difference of patients in two groups was not statistically significant.Conclusion Compared to transabdominal preperitoneal lymphadenectomy,extraperitoneal lymphadenectomy was beneficial to improvement of the living quality of patients.
作者
严金金
熊树华
刘佳
YAN Jinjin;XIONG Shuhua;LIU Jia(Jiangxi Maternal and Child Health Hospital,Nanchang,330006,China)
出处
《江西医药》
CAS
2021年第3期290-295,共6页
Jiangxi Medical Journal
基金
江西省卫生计生委科技计划,编号20175437。
关键词
宫颈癌
腹膜外
经腹膜
淋巴结切除
放射性肠炎
预后
cervical cancer
extraperitoneal
transabdominal preperitoneal
lymphadenectomy
radiation proctitis
prognosis
