腹腔镜下早期宫颈癌根治术30例临床分析

Clinical analysis of 30 cases of laparoscopic radical hysterectomy and lymph adenectomy in treatment of cervical cancer

目的探讨腹腔镜下广泛性子宫全切和盆腔淋巴结清扫术在宫颈癌手术治疗中的可行性、安全性及应用价值、并发症和远期生存率。方法选择我院早期宫颈癌30例(Ⅰa-Ⅱa)患者行腹腔镜下广泛性子宫全切和盆腔淋巴结清扫术的临床资料进行回顾性研究,包括术中出血量、手术时间、并发症、淋巴结切除总数、术后恢复及预后情况。结果手术成功率100%,30例均在腹腔镜下完成,手术时间(180±10.5)min,术中出血量(210.5±100.6)ml,切除盆腔淋巴结10-21枚;术后胃肠道功能恢复时间(2.8±0.7)d,术后留置尿管时间(15±5)d。术中并发症2例:髂血管损伤1例,膀胱损伤1例;术后近期并发症1例,为淋巴囊肿;术后远期并发症1例,为膀胱功能障碍。复发率7.6%,转移率7.7%;术后1年、3年、5年生存率分别为95.2%,87.1%,82.5%。结论腹腔镜下广泛子宫切除+盆腔淋巴结切除术治疗早期宫颈癌是安全的,行之有效的,且该术式创伤小、恢复快、疗效好,可作为早期宫颈癌手术治疗的途径之一。

Objective To investigate the probability, safety and clinical efficacy of laparoscopic radical hysterectomy and pelvic lymph node dissection for cervical cancer. Methods The clinical data and follow-up results of 30 cases of I a- 1I a cervical cancer operated under laparoscope in our hospital were retrospectively analyzed. Results The mean operative time was （ 180 ±10.5 ） min, and the blood loss was（ 210.5 ±100.6） ml. The time of bowel function recovery was （ 2.8 ± 0.7 ） d. The operative complications included one case of iliac vascular injury and one case of bladder injury,the postoperative short-term complication included one case of lymphocyst, and the long-term complication included one case of bladder dysfunction. The 1- year, 3-year, 5-year survival rates were 95.2%, 87.1% ,82.5%, respectively. Conclusion Laparoscopic surgery for cervical cancer is safe, feasible and had a better long-term effect. Laparoscopic radical hysterectomy is one of the selective methods in treatment of cervical cancer.