腹膜外盆腔淋巴结清扫及保留卵巢功能的宫颈癌根治

Study of extraperitonael pelvic lymphadenectomy and ovarian preservation with radical hysterectomy.

目的探讨年轻早期宫颈癌患者行宫颈癌根治术中,腹膜外盆腔淋巴结清扫加卵巢移位术的安全性及可行性。方法研究资料选择45例年龄为26-40岁宫颈癌I b-Ⅱa期的患者。其中,研究组 (22例)宫颈癌根治术行腹膜外盆腔淋巴结清扫+卵巢移位术,对照组(23例)行传统的宫颈癌根治术。比较两组术中及术后情况,并随访1-4年。结果研究组与对照组比较,手术时间、出血量、术后排气时间、并发症,差异有显著意义(P<0．01)。研究组术后2年卵巢功能正常。两组复发率及生存率差异无显著意义 (P>0．05)。结论腹膜外盆腔淋巴结清扫+卵巢移位的宫颈癌根治术术中出血少、恢复快、并发症少,可保留卵巢功能,不影响患者的生存率和肿瘤复发率。

Objective To investigate extraperitoneal pelvic lymphadenectomy and ovarian preservation during radical hysterectomy in young women with early stage cervical cancer. Methods Total 45 young women （age from 26-40 years old） with early stage cervical cancer （FIGO Ⅰb or Ⅱa） were studied. Extraperitoneal pelvic lymphadenectomy was done prior to radical surgery and ovarian transposition were performed at the time of radical hysterectomy in 22 cases, which was designed as the research group, only radical hysterectomy and transperitoneal pelvic lymphadenectomy was done without ovarian transposition in the other 23 cases, as the control group, The operative last time, the blood lost, and postoperative complications were recorded in all of the cases. There was a postoperative follow-up of 1 - 4 years. Results There were statistically significant difference between the research group and the control group regarding to operative last time, operative blood lost and postoperative complications （ P〈0. 01）. Normal ovarian function was preserved in the patients of the research group in 2 years after the operation. There was not a statistically significant difference between the two groups regarding to recurrence rate and survival rate （P〉0.05）. Conclusion Our results demonstrated that extraperitonael pelvic lymphadenectomy and ovarian transposition are suitable for young patients undergoing radical hysterectomy in early stage cervical cancer with preserved ovarian function, less post-operative complications, less operative blood lost and recovered more quickly.