腹腔镜手术治疗早期宫颈癌60例近期疗效分析

Treatment of early cervical carcinoma by laparoscopic surgery:a short-term analysis on 60 cases

目的探讨腹腔镜下广泛性子宫切除加盆腔淋巴结清扫术治疗早期宫颈癌的安全性、彻底性及并发症的发生情况。方法回顾性分析湖北省妇幼保健院妇科实施腹腔镜下广泛性子宫切除加盆腔淋巴结清扫术的患者60例,将其设为腹腔镜组,同期60例行开放广泛性子宫切除加盆腔淋巴结清扫术者设为开腹组,分析比较两组的手术基本情况及手术彻底性。结果腹腔镜组有1例中转开腹,中转率为1.7%。腹腔镜组在术中出血量、输血率、淋巴结切除数目、肛门排气时间、尿管留置时间及术后并发症发生率方面与开腹组相比,具有明显优势,差异均有统计学意义(P<0.05),但手术时间、住院天数及宫旁、阴道残端无瘤率,两组比较差异无统计学意义(P>0.05)。结论腹腔镜下宫颈癌广泛性子宫切除加盆腔淋巴结清扫术具有创伤小、恢复快、并发症少等优势,值得临床推广。

Objective To explore the safety,thoroughness and complications of laparoscopic hysterectomy and pelvic lymph nodes dissection to treat early cervical cancer. Methods 60 patients with early malignant uterine tumor who underwent laparoscopic radical hysterectomy and pelvic lymph nodes dissection were retrospectively reviewed and set to be the laparoscopic group.At the same time,60 patients were recruited to be the open surgery group who had laparotomy radical hysterectomy and pelvic lymph nodes dissection.Intraoperative and postoperative situations and complications between these two groups were analyzed. Results In 60 patients underwent laparoscopic operation,only one cases changed to laparotomy（transfer rate 1.7%）.Blood loss,blood transfusion rate,number of dissected pelvic lymph nodes,anal exhausting time,bladder function recovery time,occurrence of postoperative complications of the laparoscopic group were significantly different from the open surgery group（P〈0.05）,while there were no difference between these two groups on the mean operation time,hospital day and uterine vaginal cuff disease-free rate（P〉0.05）. Conclusions Treatment of cervical carcinomas by laparoscopic surgery has a quick postoperative recovery with small invasion and low complication rate and can be widely carried out.