Ⅱa期宫颈癌阴腹联合切除阴道浸润病灶10例分析

Clinical analysis of 10 invasive cervical cancer Ⅱa patients treated by combined vaginal surgery with radical abdominal hysterectomy

目的探讨阴腹联合广泛性子宫切除术用于治疗Ⅱa期宫颈癌阴道侵犯较严重的患者,并评价手术的安全性及有效性。方法采用随机对照方法,10例Ⅱa期宫颈癌广泛子宫切除术中采用阴腹联合的手术方法切除阴道侵犯病灶的患者为研究组,10例常规经腹广泛性子宫切除的患者为对照组,比较两组之间的手术时间、出血量、术中术后损伤、术后留置尿管时间、术后阴道残端病理结果、术后补充放疗、术后4个月人乳头瘤病毒(HPV)转阴等。结果两组手术均无损伤,手术时间及术中出血量相比较,差异无统计学意义(P>0.05),研究组的术后留置尿管时间稍长,但术后补充放疗的例数明显少于对照组,差异有统计学意义(P<0.05)。结论阴腹联合手术可作为Ⅱa期宫颈癌患者彻底切除阴道侵犯病灶的另一种术式。

Objective To explore the efficacy and safety of combined vaginal surgery with radical abdominal hysterectomy to treat for invasive cervical cancer Ⅱa,with parts of the procedures performed vaginally in order to resect the carcinomatous vagina quite.Methods A randomized,case-control clinical study was conducted,combined vaginal surgery with radical abdominal hysterectomy was used in 10 cases as study group,traditional radical abdominal hysterectomy was used intracervically in 10 cases as control group.Data collected included age,stage,histopathologic,estimated blood loss,perioperative blood transfusions,length of operation stay,time to resumption of normal bladder function,intraoperative and postoperative complications,complementerity cure and HPV-free interval.Results Both groups had not any injury.There was no significant difference between two groups in the operating time,bleeding estimate.Despite ureter remain time was a little bit longer,the other results were better after combined vaginal surgery with radical abdominal hysterectomy in the study group,which was significantly meaning than that of control group（P0.01）.Conclusion Combined vaginal surgery with radical abdominal hysterectomy is an alternative treatment for invasive cervical cancer Ⅱa,with parts of the procedures performed vaginally.