改良经腹广泛性子宫颈切除术治疗早期宫颈癌的临床研究

Effect of modified transabdominal radical trachelectomy in the treatment of early cervical cancer

目的探讨早期宫颈癌患者采用改良经腹广泛性子宫颈切除术的治疗效果。方法回顾性分析2014年6月至2019年10月新乡市第一人民医院收治的42例早期宫颈癌患者的临床资料,国际妇产科学联盟分期均为ⅠA2~ⅠB1期,其中实施盆腔淋巴结清扫手术+广泛性子宫颈切除术24例(设为对照组),实施盆腔淋巴结清扫手术+改良经腹广泛性子宫颈切除术18例(设为观察组)。比较两组患者术中出血量、手术用时、相关并发症、术后恢复情况、妊娠结局及肿瘤复发情况。结果两组手术成功率、相关并发症发生率、术后恢复情况比较差异未见统计学意义(P>0.05)。对照组手术操作时间为(224±27)min,长于观察组的(162±19)min,P<0.05;对照组术中出血量为(317±58)ml,多于观察组的(201±25)ml,P<0.05。术后3个月,两组患者月经周期均恢复正常,术后妊娠率比较差异未见统计学意义(P>0.05)。术后随访12~51个月,两组患者均未见复发。结论改良经腹广泛性子宫颈切除术在早期宫颈癌治疗中具有手术时间短、操作简便、出血少等优点,可明显提高手术效率。

Objective To investigate the effect of modified transabdominal radical trachelectomy in the treatment of early cervical cancer.Methods The clinical data of 42 patients with early cervical cancer treated in Xinxiang First People’s Hospital from June 2014 to October 2019 were retrospectively analyzed.All of them were IA2-IB1 stage of Federation International of Gynecology and Obstetrics.Of them,24 cases underwent pelvic lymph node dissection and radical trachelectomy(control group),18 cases underwent pelvic lymph node dissection and modified transabdominal radical trachelectomy(observation group).The intraoperative blood loss,operation time,related complications,postoperative recovery,pregnancy outcome and tumor recurrence were compared between the two groups.Results There was no significant difference between the two groups in the success rate of operation,incidence of related complications,or postoperative recovery(P>0.05).The operation time of the control group was(224±27)min,which was longer than the(162±19)min of the observation group(P<0.05).The intraoperative blood loss in the control group was(317±58)ml,which was more than the(201±25)ml in the observation group(P<0.05).The menstrual cycle of the two groups returned to normal 3 months after operation,and there was no significant difference in the pregnancy rate between the two groups(P>0.05).No recurrence was found in neither group during 12 to 51 months of follow-up.Conclusions The modified transabdominal radical trachelectomy in the treatment of early cervical cancer has the advantages of short operation time,simple operation,and less bleeding,which can significantly improve the operation efficiency.