120例早期宫颈癌患者行LNSRH术与LRH术治疗的回顾性对比研究

Retrospective comparative study on 120 patients with early cervical cancer undergoing LNSRH and LRH

目的探究腹腔镜下保留自主神经的广泛子宫切除术(LNSRH)、腹腔镜下广泛性全子宫切除术(LRH)对早期宫颈癌患者的治疗效果及安全性。方法回顾性分析2014年2月至2016年3月安徽安庆市立医院收治的早期宫颈癌手术患者的临床资料,根据手术方式的不同将其分为LRH组(62例)、LNSRH组(58例),比较围手术期指标、膀胱功能指标情况,随访统计术后复发情况。结果两组患者手术时间、术中出血量、宫旁切除长度、阴道切除长度、淋巴结清扫数目比较差异均无统计学意义(P>0.05);与LRH组比较,LNSRH组患者术后10 d尿管拔除率较高,导尿管留置时间较短(P<0.05),尿潴留及总体膀胱功能障碍发生率较低(P<0.05);两组患者术后化疗、放疗率、5年内复发率比较差异均无统计学意义(P>0.05);Kaplan-Meier生存分析显示两组患者DFS比较差异无统计学意义(P>0.05)。结论LNSRH手术与LRH手术效果相当,与LRH手术相比,LNSRH手术可降低膀胱功能障碍发生率。

Objective To explore the curative effect and safety of laparoscopic nerve sparing radical hysterectomy(LNSRH)and laparoscopic radical hysterectomy(LRH)for patients with early cervical cancer.Methods The clinical data of patients with early cervical cancer who were admitted to our hospital from February 2014 to March 2016 were retrospectively analyzed.According to different surgical methods,they were divided into LRH group(62 cases)and LNSRH group(58 cases).Perioperative indexes and bladder function indexes were compared.The postoperative recurrence was statistically analyzed by follow-up.Results There was no significant differences in operation time,intraoperative blood loss,parauterine resection length,vaginal resection length and number of lymph node dissections between the two groups(P>0.05).Compared with LRH group,after 10 days of surgery,urine extubation rate was higher in LNSRH group,while catheter indwelling time was shorter(P<0.05),incidence of urinary retention and overall bladder dysfunction was lower(P<0.05).There was no significant differences in postoperative chemotherapy,radiotherapy rate and recurrence rate within 5 years between the two groups(P>0.05).Kaplan-Meier survival analysis showed no significant difference in DFS between the two groups(P>0.05).Conclusions The effects of LNSRH and LRH are comparable.Compared with LRH,LNSRH can reduce incidence of bladder dysfunction.