摘要
目的 探讨根治性子宫颈切除术和腹腔镜下淋巴结切除术,在早期子宫颈癌治疗中的可行性和效果。方法2001年8月至2003年5月,对12例Ⅰ a期至Ⅰ b2期的子宫颈癌患者,施行腹腔镜下盆腔淋巴结切除术,切除的盆腔淋巴结经病理学检查证实无淋巴结转移者,随即行根治性子宫颈切除术,保留子宫体。结果 12例患者均在腹腔镜下完成盆腔淋巴结切除术,淋巴结检查均为阴性;根治性子宫颈切除术均经阴道完成,平均手术时间142 min(115—178 min),术中出血量约180 ml(120—230 ml)。术后无感染及出血,平均住院时间6.7 d。经随访3—28个月,1例患者妊娠,无一例肿瘤复发。结论 对于未生育且强烈要求保留生育功能的早期子宫颈癌患者,行腹腔镜下盆腔淋巴结切除术和根治性子宫颈切除术是可行的;手术创伤小,术后患者恢复快。
Objective To investigate the possibility and effect of radical vaginal trachelectomy and laparoscopic pelvic lymphadenectomy in treating women with early cervical cancers who desired to maintain fertility. Methods From August 2001 through May 2003, we performed vaginal radical trachelectomy with laparoscopic lymphadenectomy on 12 patients with biopsy-proven early stage cervical carcinomas. Subjects were selected for this treatment on the basis of favorable cervical tumors and a desire to maintain fertility. Pelvic lymphadenectomies were performed in all patients. Vaginal radical trachelectomy was performed immediately if lymph nodes were negative. Results Twelve women underwent this procedure. The median age was 27. 6 years (range 24-31 years) ; 10 were nulligravid and 2 were multipara. Mean operative time was 142 min( 115-178 min) , with a mean blood loss of 180 ml( 120-230 ml) , and an average hospital stay of 6. 7 days. There was no intra- or post-operative complication. With an average follow-up of 21. 5 months, there have been no recurrences. One woman has become pregnant. Conclusions Radical vaginal trachelectomy with laparoscopic pelvic lymphadenectomy permits preservation of fertility in selected patients. It is mini-invasive, and needs shorter recovery time.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2004年第5期305-307,共3页
Chinese Journal of Obstetrics and Gynecology
