腹腔镜下自体组织提拉法C2型子宫切除在早期宫颈癌治疗中的应用

Application of laparoscopic type C2 hysterectomy using autogenous tissue lifting method in treatment of early-stage cervical cancer

目的探讨腹腔镜下自体组织提拉法C2型子宫切除在早期宫颈癌治疗中的安全性和有效性。方法回顾性分析2020年1月至2022年9月在安顺市人民医院妇科接受腹腔镜下自体组织提拉法C2型子宫切除术的43例早期宫颈癌患者的临床资料,记录手术时间、术中出血量、阴道切除长度、淋巴结切除数量、术中术后并发症、排气时间、住院时间、拔除尿管时间、术后病理情况、术后辅助治疗以及术后随访生存结局。结果43例患者中ⅠB1期15例,ⅠB2期15例,ⅡA1期13例;鳞癌37例,腺癌5例,腺鳞癌1例。手术时间为(186.28±23.40)min,术中出血量为(167.44±109.52)mL;术中发生输尿管损伤1例,术后发生淋巴漏2例。阴道切除长度为(3.08±0.41)cm,淋巴结切除数量为(26.98±10.48)枚,20例患者同时接受了腹主动脉旁淋巴结清扫术。术后随访截至2024年3月31日,1例患者于术后16个月复发,无死亡患者,累积总生存(OS)率为100.00%,累积无进展生存(PFS)率为97.06%。结论腹腔镜下自体组织提拉法C2型子宫切除术应用于早期宫颈癌的治疗,安全有效,简便易行,更好地遵从无瘤原则,肿瘤学预后较好,值得在临床推广应用。

Objective To explore the safety and efficacy of laparoscopic type C2 hysterectomy using autogenous tissue lifting method in treatment of early-stage cervical cancer.Methods The clinical data of 43 patients with early-stage cervical cancer who underwent laparoscopic type C2 hysterectomy using autogenous tissue lifting method in the Department of Gynecology of People's Hospital of Anshun City from January 2020 to September 2022 were retrospectively analyzed.The duration of operation,amount of intraoperative blood loss,length of vagina resected,number of lymph nodes resected,intraoperative and postoperative complications,time of exhaust,length of hospital stay,time of catheter extraction,results of postoperative pathological examination,postoperative adjuvant treatment and postoperative follow-up survival outcome were recorded.Results Among the 43 patients,there were 15 patients with International Federation of Gynecology and Obstetrics(FIGO)stage ⅠB1,15 patients with FIGO stage ⅠB2,and 13 patients with FIGO stage ⅡA1.Among the 43 patients,37 patients suffered from squamous cell carcinoma,and 5 patients suffered from adenocarcinoma,and 1 patient suffered from adeno-squamous carcinoma.The operation time was(186.28±23.40)minutes and the intraoperative blood loss was(167.44±109.52)milliliters.Intraoperative ureteral injury occurred in 1 case and postoperative lymphorrhea occurred in 2 cases.The length of vagina resected was(3.08±0.41)centimeters,and the number of lymph nodes resected was(26.98±10.48)pieces.Twenty patients also underwent para-aortic lymph node dissection.After the operation,the patients were followed up until March 31,2024,and it was found that 1 patient relapsed 16 months after the operation and no deaths occurred with a cumulative overall survival(OS)rate of 100.00% and a cumulative progression-free survival(PFS)rate of 97.06%.Conclusion Application of laparoscopic type C2 hysterectomy using autogenous tissue lifting method is safe,effective,simple and easy to operate in treatment of early-stage cervical cancer.It can better follow the principle of no tumor and has a good prognosis in oncology,and is worthy of clinical promotion and application.