广泛宫颈切除术治疗宫颈癌的手术要点及临床疗效观察

The operation key points and clinical curative effect of radical trachelectomy in cervical cancer

目的探讨广泛宫颈切除术治疗宫颈癌的手术要点及临床疗效。方法选取宫颈癌患者110例,按照手术方法不同将患者分为观察组(n=56)与对照组(n=54),观察组进行腹腔镜下广泛宫颈切除术,对照组进行开腹式广泛宫颈切除术,比较两组治疗效果。结果观察组患者手术时间长于对照组,术中出血量少于对照组,切除淋巴结个数多于对照组(P﹤0.05);观察组肛门排气时间、排便时间、拔除引流管时间、抗生素使用时间、住院时间均短于对照组(P﹤0.05);观察组并发症总发生率低于对照组(P﹤0.05);通过随访,两组患者复发率比较,差异无统计学意义(P﹥0.05),观察组生存率、妊娠率高于对照组(P﹤0.05)。结论在宫颈癌患者中行腹腔镜下广泛宫颈切除术效果显著,值得推广应用。

Objective To study the operation key points and clinical curative effect of radical trachelectomy in cervi-cal cancer. Method 110 patients with cervical cancer were enrolled, of which, 56 cases were assigned to observation group and 54 cases to control group according to their operation type. Patients in observation group were treated with lap-aroscopic radical trachelectomy and those in control group were treated with transabdominal radical trachelectomy, and curative effects were compared between two groups. Result The operation time of the observation group was longer than that of the control group, the intraoperative blood loss of observation group was less than that of the control group, and patients in observation group had more lymph nodes resected than those in control group （P〈0.05）;the anal exhaust time, defecation time, drainage tube removal time, antibiotic treatment duration and hospital stay of the observation group were shorter than those of control group （P〈0.05）;the total incidence of complications in observation group were lower that of control group （P〈0.05）;according to the follow-up results, there was no significant difference in the recurrence rate between the two groups （P〉0.05）, the survival rate and pregnancy rate of observation group were higher than those of control group （P〈0.05）. Conclusion Laparoscopic radical trachelectomy has achieved significant curative effect in patients with cervical cancer, and it＇s worthy of promotion and application.