609例宫颈癌根治术的临床分析

Radical hysterectomy for cervical cancer: Clinical review in 609 cases

目的：回顾分析609例宫颈癌临床资料,评价不同手术方式的临床效果。方法：选取2003年1月~2012年12月于皖南医学院第一附属医院妇科行宫颈癌根治术的患者609例,随访患者的病例资料。回顾总结十年来我院宫颈癌根治性手术的发展及并发症情况。结果：宫颈癌根治术的术后近期并发症以尿潴留、淋巴囊肿为主。将2003~2007年和2008~2012年的患者分为A、B两组,A组切除淋巴结数（22.60±9.20）个明显少于B组淋巴结（27.98±9.58）个,B组出血量（512.37±271.71）m L明显少于A组出血量（645.88±252.94）m L,手术时间B组（254.79±60.55）min明显少于A组（300.95±79.40）min。其中腹腔镜组术中出血量少于同期传统宫颈癌根治术,而清扫淋巴结数明显增多,差异有统计学意义（P〈0.05）。结论：合理的手术方式、精细的盆腔解剖和熟练的手术操作可以减少手术创伤,保证手术安全有效的切除范围,增加盆腔淋巴结清扫数目,减少术后并发症的发生,改善患者生活质量。

Objective：To retrospectively analyze the outcomes of different surgical procedures for cervical cancer. Methods：The clinical data, including follow-up information, surgical modality and complications, were reviewed in 609 eases of cervical cancer undergone radical hysterectomy in our department between January 2003 and December 2012. Then the surgieal patients were divided into group A（2003 -2007） and group B（2008 -2012） for compari- son of the outcomes. Results：Short-term complieations after procedure were associated primarily with urinary retention and lymphatic cyst. The number of lymph nodes resected in group A were fewer [ （ 22.60 ± 9.20 ） vs. （ 27.98 ± 9.58 ） ] , and group B had lower blood loss and shorter operative time [ （ 512.37 ± 271.71 ） vs. （645.88± 252.94 ） ; （254.79± 60.55 ） min vs. （ 300.95 ± 79.40 ） min ]. Patients treated with laparoseopy had lower blood loss and had more lymph nodes reseeted than conventional surgery, and the difference was statistically significant （ P 〈 0.05 ）. Conclusion ： Sound surgical mo- dality, careful dissection complying to the pelvic anatomy and skillful operation may ensure safe surgery and complete resection of the pelvic lymph node in- volved, and reduce the postoperative complications as well as improve the quality of life of patients.