早期宫颈癌手术方式的研究进展

Research Progress on Surgical Treatment of Early Cervical Cancer

早期宫颈癌手术方式主要包括开腹手术和腹腔镜手术,由于缺乏一项满意的前瞻性随机对照研究来证明这两种手术方式之间的差异,所以对于早期宫颈癌最佳手术方式的选择一直以来争议不断。近期发表的两项早期宫颈癌腹腔镜子宫切除术对比开腹子宫切除术的研究使大家对两种手术方式的选择有了重新认识,开腹手术组的总生存率和无病生存率明显高于腹腔镜手术组,而腹腔镜手术组的局部复发率和累积死亡率明显高于开腹手术组,两者的术后并发症和1周后生活质量则无明显差异。因此开腹手术被认为是早期宫颈癌广泛子宫切除术的标准程序,但并不能因此完全否定腹腔镜手术价值,应该对腹腔镜手术中存在的问题加以改进。

Laparotomy and laparoscopy are two main surgical modalities for treatment of early cervical cancer.Due to lack of data from prospective randomized controlled trials,there has been controversy about the choice of surgical approaches for early cervical cancer.However,two recently published studies have brought new insight into the choice of laparoscopy or laparotomy for treatment of early cervical cancer.The overall survival rate and disease-free survival rate of the laparotomy group were significantly higher than those of the laparoscopy group.The local recurrence rate and cumulative mortality of the laparoscopy group were significantly higher than those of the laparotomy group.There were no significant differences in the postoperative complications and the quality of life after 1 week of the procedure between two approaches.Therefore,laparotomy is considered to be the standard procedure for extensive hysterectomy for early cervical cancer,but the advantages of laparoscopy should not be neglected and its related problems should be improved.