腹腔镜保留自主神经广泛子宫切除术对子宫颈癌的疗效

Effect of Laparoscopic Autonomic Nerve-preserving Extensive Hysterectomy on Cervical Cancer

目的 探讨腹腔镜下保留自主神经的广泛子宫切除术治疗早期子宫颈癌的临床效果及安全性。方法 选取2019年1月—2020年6月拟行外科手术治疗的80例早期子宫颈癌患者作为研究对象。采用随机数字表法将其分为观察组与对照组,对照组40例接受常规腹腔镜下广泛性全子宫切除术治疗,观察组40例行腹腔镜下保留自主神经的广泛性子宫切除术,对比两组手术治疗效果及术后并发症、复发情况。结果 两组手术用时、术中出血量、宫旁切除长度、阴道切除长度以及淋巴结清扫数目比较,差异无统计学意义(P> 0.05);观察组术后10 d导尿管拔除率明显低于对照组,且观察组导尿管留置时间、住院时间均明显低于对照组(P<0.05);观察组术后尿潴留、尿失禁等膀胱功能障碍总发生率明显低于对照组(P<0.05)。结论 腹腔镜保留自主神经的广泛子宫切除术与腹腔镜下广泛性全子宫切除术均可作为早期子宫颈癌的有效外科手术治疗手段,疗效确切,但腹腔镜保留自主神经的广泛子宫切除术后并发症发生率更低,在安全性方面更具优势。

Objective To investigate the clinical efficacy and safety of laparoscopic extensive hysterectomy with autonomic nerve preservation in the treatment of early cervical cancer.Methods A total of 80 cases of early cervical cancer planned to undergo surgical treatment from January 2019 to June 2020 were selected as the research object.They were randomly divided into observation group and control group.40 cases in the control group were treated with routine laparoscopic extensive hysterectomy,and 40 cases in the observation group were treated with laparoscopic extensive hysterectomy preserving autonomic nerve.The surgical treatment effects,postoperative complications and recurrence of the two groups were compared.Results There were no significant differences in operation time,intraoperative blood loss,length of parahysterectomy,length of vaginal resection and number of lymph node dissections between the two groups(P>0.05).The removal rate of catheter in the observation group 10 days after operation was significantly lower than that in the control group,and the urinary catheter indwelling time and hospital stay in the observation group were significantly lower than those in the control group(P< 0.05);the total incidence of postoperative urinary retention,urinary incontinence and other bladder dysfunction in the observation group were significantly lower than that in the control group(P< 0.05).Conclusion Laparoscopic extensive hysterectomy with autonomic nerve preservation and laparoscopic extensive total hysterectomy can be used as effective surgical treatment for early cervical cancer,with definite curative effect,but the incidence of complications after laparoscopic extensive hysterectomy with autonomic nerve preservation is lower and has more advantages in safety.