早期宫颈癌手术治疗方式的争议及原因分析

Controversy over Surgical Treatment of Early-Stage Cervical Cancer and Causes Analysis

宫颈癌是妇科最常见的恶性肿瘤之一,早期宫颈癌的主要治疗方法包括开腹手术和微创手术两种模式。开腹宫颈癌根治术作为传统术式,其缺点为手术创伤大、出血量多、术后脏器功能恢复慢等,微创手术因具有创伤小、出血量少、术后恢复快等优势而被多数妇科专家推崇,尽管既往大多文献已证实微创手术的安全性、有效性及可行性,但远期预后尚缺乏成熟的研究,直至2018年国际权威性新英格兰杂志刊登的腹腔镜治疗宫颈癌的前瞻性研究和早期宫颈癌微创手术结局的大型回顾性研究结果显示,腹腔镜的应用导致宫颈癌复发率升高及远期预后较差,引起国际范围的争议。理性分析可能影响宫颈癌微创手术预后的因素并加以改进是今后微创手术的发展方向,为宫颈癌患者提供更有效和更先进的外科治疗手段。

Cervical cancer is one of the most common malignant tumors in gynecology.The main treatment methods for early cervical cancer include abdominal surgery and minimally invasive surgery.Abdominal radical hysterectomy,a traditional surgical procedure for early-stage cervical cancer,has disadvantages of large surgical trauma,large amount of bleeding,and slow recovery of postoperative organ functions.Minimally invasive surgery is praised by most gynecologists for its advantages of less trauma,less blood loss,and rapid recovery.Although it is suggested that laparoscopy ensures the endpoints of safety,feasibility and efficacy,no mature data on oncologic results exists.A prospective study and a large retrospective study of early-stage cervical cancer,which published in the New England Journal of Medicine in 2018,have shown that laparoscopic applications led to an increased recurrence rates and a decline in long-term prognosis,leading to international controversy.It is important to analyze the factors that may affect the prognosis of minimally invasive surgery for cervical cancer,providing the most effective and advanced surgical treatment for cervical cancer patients.