保留生育功能的宫颈根治术及宫颈切除术13例临床分析

Clinical analysis on 13 cases of cervical radical mastectomy and cervical resection-keeping reproductive function

目的探讨根治性宫颈切除术及宫颈切除术在早期宫颈癌治疗中的可行性及临床疗效。方法对2006年4月至2011年12月,13例Ⅰa1～Ⅰb1期宫颈癌患者,8例施行根治性宫颈切除术,5例Ⅰa1期实施宫颈切除术,观察其手术时间、出血量、术后并发症、术后生存及生育情况。结果宫颈根治术平均手术时间(3.5±0.7)h(3～5h),术中平均出血量(419±80)mL(300～550mL),宫颈切除术平均手术时间(1.20±0.19)h,术中平均出血量(80±27)mL。术后1个月内恢复正常月经,术后5例发生淋巴囊肿;术后平均随访34.3个月(16～50个月),13例患者生存至今,其中1例成功受孕并生育。结论对Ⅰa1～Ⅰb1期年轻宫颈癌患者,行保留生育功能的手术是可行的;对Ⅰb2期及以上患者,应视为宫颈根治术的相对禁忌证;Ⅰa1期宫颈癌患者可施行宫颈切除术。

Objective To explore the clinical feasibility and curative rate of radical cervical resection and cervical resection in the early cervical cancer. Methods From April 2006 to December 2011, thirteen cases of I a1 -I b1 stage cervical cancer patients were collected. In these 13 patients, eight cases underwent radical cervical resection, 5 cases that was I al stage just was operated in the method of cervical resection. We observed the operation time, the amount of bleeding, postoperative complications, survival time and situation of child birth. Results The average operation time of cervical radical mastectomy was （3.5±0.7）hours, and average amount of bleeding was （419±80）mL. On average, the operation time of cervical resection was （1.20±0.19）hours and bleeding was （80±27）mL. All patients were recurred normal menstruation in one month after operation. After a mean follow- up of 34.3 months （16-50 months）, thirteen patients live up till now. One patient got a successful pregnancy and birth. Conclusion For young cervical cancer patients of I al - I bl stage, the surgery of keep reproductive function is feasible. For I b2 and above stage patients, cervical radical mastectomy and cervical resection should be regarded as contraindication.