腹腔镜保留盆腔神经的广泛子宫切除治疗子宫肿瘤

目的回顾性分析腹腔镜下保留盆腔自主神经的广泛子宫切除术在子宫肿瘤患者治疗中的可行性。 方法选择2013年8月至2015年6月在新乡市中心医院接受手术治疗的早期宫颈癌及Ⅱ期子宫内膜癌患者95例，其中43例患者接受腹腔镜保留盆腔神经的广泛子宫切除术 ＋ 盆腔淋巴结清扫术(A组)，52例患者行经腹广泛子宫切除 ＋ 盆腔淋巴结清扫术(B组)。总结两组的手术时间、术中出血量、切除宫旁组织及阴道长度、淋巴结数量，以及术后膀胱、直肠及性功能恢复情况。 结果两组的手术时间、切除范围及淋巴结数量差异无统计学意义(P> 0.05)；两组的术中出血量，以及术后膀胱、直肠及性功能评估治疗比较[(180±55)ml vs (340±75)ml, (51.2±10.3)h vs (74.9±12.8) h, (11.6±2.1) d vs (18.3±2.9) d, 19.9分 vs 23.4分]，差异有统计学意义(P<0.05)。 结论腹腔镜下保留盆腔神经的广泛子宫切除术在子宫肿瘤中是安全可行的，与传统术式相比更有利于膀胱直肠功能恢复，提高生命质量。

Clinical analysis on laparoscopic nerve sparing radical hysterectomy in malignant uterine cancer

ObjectiveTo explore the efficacy of laparoscopic nerve sparing radical hysterectomy for malignant uterine cancer. MethodsNighty-five patients with early cervical cancer and endometrial cancer received surgery from Aug.2013 to Jun. 2015 in Central Hospital of Xinxiang, 43 cases underwent laparoscopic nerve sparing radical hysterectomy pelvic lymphadenectomy, 52 cases underwent radical hysterectomy combined pelvic lymphadenectomy. The data of operating time, blood loss, excision extent, numbers of lymph node, the postoperative function of bladder, rectal and sexual were assessed. ResultsThere were not remarkable difference in terms of operating time, excision extent, number of lymph node, duration of hospital stays. The data of blood loss, the postoperative function of bladder, rectal and sexual reached statistical difference [(180±55)ml vs (340±75)ml, (51.2±10.3)h vs (74.9±12.8) h, (11.6±2.1) d vs (18.3±2.9) d, 19.9 points vs 23.4 points] (P<0.05). ConclusionsLaparoscopic nerve sparing radical hysterectomy pelvic lymphadenectomy can remarkably improve postoperative function of bladder, rectal, sexual and psychological status, so it is safe and feasible for early cervical cancer and endometrial cancer.