腹腔镜广泛子宫切除术中保留盆腔自主神经的临床价值

Clinical Value of Pelvic Autonomic Nerve Preservation in Laparoscopic Hysterectomy

目的探讨腹腔镜广泛子宫切除术中保留盆腔自主神经(laparoscopic nerve-sparing radical hysterectonmy,LNSRH)的临床价值,评估术后膀胱功能恢复的效果。方法选择我院ⅠA-ⅡA期宫颈癌患者17例。研究组7例应用LNSRH术,术中保留盆腔自主神经;对照组10例患者用传统腹腔镜子宫广泛切除术(laparoscopic radical hysterectonmy,LRH)。对比分析两组手术时间、术中出血量、术后膀胱功能恢复及术后并发症情况。结果研究组手术时间(286.6±38.6min)长于对照组(238.5±31.2min)(P<0.05),研究组术中出血量(267.5±83.2ml)与对照组(243.5±81.1ml)差异无统计学意义(P>0.05),术后研究组留置尿管时间(11.3±2.5天)明显短于对照组(16.5±7.8天)(P<0.05)。两组患者均无手术并发症及肿瘤切缘不净情况发生。结论 LNSRH治疗早期宫颈癌安全、可行,能明显改善术后的膀胱功能,提高患者的生活质量。

Objective This study aimed to investigate the clinical value of laparoscopic nerve-sparing radical hyster- eetonmy（LNSRH）. Methods A total of 17 case of cervical cancer patients were selected in our hospital. In the study group,7 patients were treated with LNSRH, and the autonomic nerve was reserved in the control group. The control group of 10 patients with laparoscopic radical hysterectonmy（LRH）. The operation time,intraoperative blood loss, postoperative recovery of bladder function and postoperative complications were compared between the two groups. Results The operative time of the study group （286.6±38.6min） was longer than that of the control group （238.5±31.2min） （P〈0.05）. The blood loss in the study group（267.5±83.2ml）was no significant difference from the control group （243.5±81. lml）（P〉0.05）. The study group of postoperative indwlling catheter time （11.3±2.5 days） was significantly shorter than the control group （16.5±7.8 days）. There were no surgical complications and unclean margin of the tumor in the two groups. Conclusion LNSRH is safe and feasible in the treatment of early cervical cancer, which can significantly improve the postoperative bladder function and the quality of life of patients.