改良式卵巢移位术在子宫颈癌根治术中的应用

Study on Intraperitoneal Ovarian Transposition in Radical Surgery of Early Cervical Carcinoma

目的 :观察对 4 5岁以下的子宫颈癌患者施行改良式卵巢移位术后的并发症和卵巢内分泌变化。方法 :改良式卵巢移位术组 (侧中腹腹膜内卵巢移位术 ) 4 2例 ,对照组 (侧中腹腹膜外卵巢移位术 ) 16例。两组 5 8例病例术前和术后 (包括放疗后 )半年 ,均用微粒子化学发光法测定血清性激素。结果 :5 8例患者术前和术后 6月卵巢功能均无明显变化 (P >0 .0 5 )。但改良式卵巢移位术组无一例发生并发症 ,而对照组并发症发生率为 4 3.75 % ,差异有非常显著性 (P<0 .0 1)。结论 :任何一种卵巢移位术 ,只要卵巢远离盆腔 ,术后即可避免放疗破坏卵巢功能。但在减轻并发症方面 ,腹膜内卵巢移位术明显优于腹膜外卵巢移位术。

Objective: To observe the ovarian function in patients under 45 years old with early cervical carcinoma after ovarian transposition. Methods: Treated group receiving intraperitoneal ovarian transposition: 42 young patients with early cervical carcinoma were treated by intraperitoneal ovarian transposition during radical surgery. Their ovaries were displaced to 2～4 cm above the iliac crest intraperitoneal. Control group: 16 young patients with early cervical carcinoma were treated by extraperitoneal ovarian transposition. 18 of treated group and 3 of control group were also received pelvic radiotherapy after operation 20 days. Before-operation, 6 month post-operation, and after radiotherapy, the serum levels of sex hormones in these patients were detected by radioimmunoassay. Results: There was no significant difference in term of the change of sex hormone before- and after-operation, and after radiotherapy between two groups( P >0.05). Treated group had no complication, but the prevalence of complication in control group was 43.75%(7/16), that had significant difference between two groups( P <0.01). Conclusions: Ovarian transposition was helpful for reserving ovarian function in young patients with cervical carcinoma who would undergo radiotherapy. Intraperitonealy ovarian transposition leads to less complications than extraperitoneal way.