Ⅲ型与Ⅰ型全子宫根治切除术治疗早期宫颈癌临床疗效和安全性的对比研究

TotalⅢtype andⅠtype hysterectomy treatment of early cervical cancer radical resection of the comparsion of the clinical efficacy and safety

目的:探讨Ⅲ型和Ⅰ型全子宫根治切除术治疗直径≤2 cmⅠb1期宫颈癌疗效及安全性差异,为制定更佳的手术方案积累循证医学证据。方法:选取我院2012年01月至2016年10月收治直径≤2 cmⅠb1期宫颈癌患者共132例,其中82例采用Ⅲ型全子宫根治切除术治疗设为对照组,50例采用Ⅰ型全子宫根治切除术治疗设为观察组,比较两组手术相关临床指标,手术相关并发症发生率,随访OS率、PFS率及复发率。结果:观察组手术操作时间、术中失血量、输血率、术后胃肠蠕动恢复时间及术后住院时间显著少于对照组(P<0.05);两组盆腔淋巴结清扫数量比较差异无统计学意义(P>0.05);观察组术中术后相关并发症发生率均显著低于对照组(P<0.05);两组随访OS率、PFS率及复发率比较差异无统计学意义(P>0.05)。结论:相较于Ⅲ型全子宫根治切除术,Ⅰ型全子宫根治切除术治疗直径≤2 cmⅠb1期宫颈癌可有效降低术中创伤,促进术后康复,并有助于预防术中术后并发症出现,同时两种手术方案在患者生存获益方面接近。

Objective:To investigate the clinical effects and safety difference of type Ⅰ and type Ⅲ radical hysterectomy in the treatment of patients with cervical cancer for stage Ⅰb1 and tumor parameter ≤2 cm.Methods:132 patients with cervical cancer for stage Ⅰb1 and tumor parameter ≤2 cm were chosen in the period from January 2012 to October 2016 in our hospital and divided into 2 groups including control group(82 patients) with type Ⅲ radical hysterectomy and observation group(50 patients) with type Ⅰ radical hysterectomy, and the operation-related clinical indicators, operation-related complications incidence, OS rate, PFS rate and recurrence rate with follow-up of 2 groups were compared.Results:The operation time, intraoperative blood loss volume, blood transfusion rate, postoperative gastrointestinal function recovery time and hospitalization time after operation of observation group were significant less than control group(P<0.05).There was no significant difference in the pelvic lymph node clearance number between 2 groups(P>0.05). The incidence of intraoperative and postoperative complications of observation group were significant lower than control group( P < 0. 05). There was no significant difference in the OS rate,PFS rate and recurrence rate with follow-up between 2 groups( P > 0. 05). Conclusion: Compared with type Ⅲ radical hysterectomy,type Ⅰ radical hysterectomy in the treatment of patients with cervical cancer for stage Ⅰb1 and tumor parameter≤2 cm can efficiently reduce intraoperative trauma degree,promote post-operative rehabilitation process,prevent intraoperative and post-operative complications and possess the same survival time benefits.