Background Nerve-sparing radical hysterectomy （NSRH） was developed in an attempt to minimize complications after radical hysterectomy.Since 2008,a modified NSRH-nerve plane-sparing radical hysterectomy （NPSRH） has...Background Nerve-sparing radical hysterectomy （NSRH） was developed in an attempt to minimize complications after radical hysterectomy.Since 2008,a modified NSRH-nerve plane-sparing radical hysterectomy （NPSRH） has been developed at the Cancer Hospital,Chinese Academy of Medical Sciences.The aim of this study was to investigate the role of NPSRH in improving postoperative pelvic visceral dysfunctions.Methods Eighty-three patients with International Federation of Gynecology and Obstetrics （FIGO） stage IB1-IIA2 cervical cancer received NPSRH （the study group） from January 2008 to October 2012.One hundred and sixty-six patients who underwent conventional radical hysterectomy （CRH） were randomly selected as the control group.Age,pathological type and stage were matched between the two groups.The safety of surgery was assessed by duration of operation and blood transfusion rate.Postoperative short-term bladder function was analyzed by duration of catheterization.Long-term bladder,anorectal and sexual function were evaluated with questionnaires.Results Seventy-eight patients （94.0%） in the NPSRH group and one hundred and sixty patients （96.4%） in the CRH group completed the study.Median follow-up time was 31.9 months and 31.0 months respectively （P=0.708）.There was no significant difference between the two groups in terms of age,body mass index,FIGO stage,pathologic type,preoperative and postoperative therapy （P 〉0.05）.The blood transfusion rate shared no difference between two groups （P=0.364）.The operation time in the NPSRH group was significantly longer than CRH group （P 〈0.01）.But the duration of catheterization and hospitalization in the NPSRH group was significantly reduced compared with CRH group （P 〈0.01）.In addition,the incidence of long-term urinary frequency,urinary incontinence,urinary retention,straining to void,constipation and diarrhea was significantly lower in the NPSRH group （P 〈0.05）.However,there was no significant difference regarding sexua展开更多
目的:探讨内镜下负压套扎术对Ⅱ、Ⅲ度痔疮患者肛肠动力学、炎症反应及免疫功能的影响。方法:选择2021年3月到2023年3月期间邯郸市中心医院收治的120例Ⅱ、Ⅲ度痔疮患者。按照手术方式的不同将患者分为A组(传统外剥内扎术,n=58)和B组(...目的:探讨内镜下负压套扎术对Ⅱ、Ⅲ度痔疮患者肛肠动力学、炎症反应及免疫功能的影响。方法:选择2021年3月到2023年3月期间邯郸市中心医院收治的120例Ⅱ、Ⅲ度痔疮患者。按照手术方式的不同将患者分为A组(传统外剥内扎术,n=58)和B组(内镜下负压套扎术,n=62)。对比两组围术期指标、肛肠动力学、炎症反应及免疫功能变化情况,同时观察两组并发症发生率。结果:B组术中出血量少于A组,手术时间、首次排便时间、住院时间短于A组,术后24 h疼痛视觉模拟量表(VAS)评分低于A组(P<0.05)。两组术后3个月直肠最大耐受量、直肠感觉阈值、肛管静息压、肛管最大收缩压下降,且B组低于A组(P<0.05)。两组术后3 d白介素-6(IL-6)、白介素-8(IL-8)、白介素-12(IL-12)、C反应蛋白(CRP)升高,但B组低于A组(P<0.05)。两组术后3 d CD8^(+)升高,但B组低于A组,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)下降,但B组高于A组(P<0.05)。B组的并发症发生率低于A组(P<0.05)。结论:与传统外剥内扎术治疗相比,内镜下负压套扎术用于Ⅱ、Ⅲ度痔疮,具有创伤小,术后恢复快的优势,同时还可促进机体肛肠动力学恢复,减轻炎症反应和免疫抑制,降低术后并发症发生率。展开更多
文摘Background Nerve-sparing radical hysterectomy （NSRH） was developed in an attempt to minimize complications after radical hysterectomy.Since 2008,a modified NSRH-nerve plane-sparing radical hysterectomy （NPSRH） has been developed at the Cancer Hospital,Chinese Academy of Medical Sciences.The aim of this study was to investigate the role of NPSRH in improving postoperative pelvic visceral dysfunctions.Methods Eighty-three patients with International Federation of Gynecology and Obstetrics （FIGO） stage IB1-IIA2 cervical cancer received NPSRH （the study group） from January 2008 to October 2012.One hundred and sixty-six patients who underwent conventional radical hysterectomy （CRH） were randomly selected as the control group.Age,pathological type and stage were matched between the two groups.The safety of surgery was assessed by duration of operation and blood transfusion rate.Postoperative short-term bladder function was analyzed by duration of catheterization.Long-term bladder,anorectal and sexual function were evaluated with questionnaires.Results Seventy-eight patients （94.0%） in the NPSRH group and one hundred and sixty patients （96.4%） in the CRH group completed the study.Median follow-up time was 31.9 months and 31.0 months respectively （P=0.708）.There was no significant difference between the two groups in terms of age,body mass index,FIGO stage,pathologic type,preoperative and postoperative therapy （P 〉0.05）.The blood transfusion rate shared no difference between two groups （P=0.364）.The operation time in the NPSRH group was significantly longer than CRH group （P 〈0.01）.But the duration of catheterization and hospitalization in the NPSRH group was significantly reduced compared with CRH group （P 〈0.01）.In addition,the incidence of long-term urinary frequency,urinary incontinence,urinary retention,straining to void,constipation and diarrhea was significantly lower in the NPSRH group （P 〈0.05）.However,there was no significant difference regarding sexua
文摘目的:探讨内镜下负压套扎术对Ⅱ、Ⅲ度痔疮患者肛肠动力学、炎症反应及免疫功能的影响。方法:选择2021年3月到2023年3月期间邯郸市中心医院收治的120例Ⅱ、Ⅲ度痔疮患者。按照手术方式的不同将患者分为A组(传统外剥内扎术,n=58)和B组(内镜下负压套扎术,n=62)。对比两组围术期指标、肛肠动力学、炎症反应及免疫功能变化情况,同时观察两组并发症发生率。结果:B组术中出血量少于A组,手术时间、首次排便时间、住院时间短于A组,术后24 h疼痛视觉模拟量表(VAS)评分低于A组(P<0.05)。两组术后3个月直肠最大耐受量、直肠感觉阈值、肛管静息压、肛管最大收缩压下降,且B组低于A组(P<0.05)。两组术后3 d白介素-6(IL-6)、白介素-8(IL-8)、白介素-12(IL-12)、C反应蛋白(CRP)升高,但B组低于A组(P<0.05)。两组术后3 d CD8^(+)升高,但B组低于A组,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)下降,但B组高于A组(P<0.05)。B组的并发症发生率低于A组(P<0.05)。结论:与传统外剥内扎术治疗相比,内镜下负压套扎术用于Ⅱ、Ⅲ度痔疮,具有创伤小,术后恢复快的优势,同时还可促进机体肛肠动力学恢复,减轻炎症反应和免疫抑制,降低术后并发症发生率。
