腹腔镜辅助阴式子宫广泛切除术对宫颈癌患者近期疗效和预后的影响

Laparoscopic-assisted Vaginal Radical Hysterectomy: Feasibility and Operative Results

目的探讨腹腔镜辅助阴式子宫广泛切除术治疗对子宫颈恶性肿瘤患者近期疗效和预后状况的影响。方法选取我院妇科宫颈癌患者167例,其中腹腔镜辅助阴式子宫广泛切除术治疗患者作为观察组(97例),开腹广泛子宫切除术治疗患者作为对照组(70例),比较两组患者近期疗效和预后状况的差异。结果观察组手术时间、术中出血量、术中盆腔引流量、术后排气时间、术后体温恢复时间、术后导尿管留置时间和术后抗生素应用时间均明显低于对照组,输血率、镇痛药物应用率和并发症发生率均明显低于对照组,两组比较差异具有统计学意义(P<0.05)。术后随访3年发现,观察组性功能障碍率明显低于对照组,两组比较差异具有显著性(P<0.05),但两组复发率和生存率比较差异无统计学意义(P>0.05)。结论腹腔镜辅助阴式子宫广泛切除术治疗宫颈癌患者近期疗效更显著,在不影响术后复发和生存时间的基础上改善性生活质量,值得临床推广应用。

Objective To investigate the clinical study of efficacy and prognosis for cervical cancer by laparoscopic-assisted vaginal radical hysterectomy. Methods 167 cases of cervical cancer patients were se- lected, including 97cases of observation group received laparoscopic assisted operation, and 70 cases of control group received laparotomy surgery. Differences of curative effect and prognosis between groups were compared. Results The operation time, intraoperative blood loss, pelvic drainage volume, postoperative exhaust time, postoperative antibiotic application of recovery time and postoperative indwelling catheter time in the observation group were significantly lower than control group （ P 〈 0.05 ）. The blood transfusion rate, analgesic drug appli- cation rate and complications incidence of the observation group were significantly lower than the control group as well（P 〈0.05）. 3-year postoperative follow-up showed that sexual dysfunction of the observation group was significantly lower than that of the control group （P 〈 0.05 ）, but the relapse rate and survival rate between the two groups had no significant difference （P 〉 0.05）. Conclusion The laparoscopic-assisted vaginal radical hysterectomy is a feasible and oncologically safe surgical option for patients with early-stage cervical cancer, which can improve female sexual function with no influence of the recurrence and survival time, and is worthy of clinical application.