早期宫颈癌腹腔镜和开腹根治性手术的病例对照研究

目的：探讨腹腔镜宫颈癌根治手术的可行性、安全性及优势。方法回顾性分析2005年1月～2010年3月广泛子宫切除＋盆腹腔淋巴结切除术治疗的早期宫颈癌（ⅠB～ⅡA期）患者资料,根据患者年龄、肿瘤分期、肿瘤组织学类型和淋巴结转移情况对接受腹腔镜和开腹手术的患者进行1∶1配对病例对照分析,2组各21例。比较2组手术指标、术后病理结果及随访结果。结果2组手术时间及并发症发生率差异无显著性,腹腔镜组术中出血少[（233．3±202．1） ml vs．（983.3±462．2）ml,t＝-6．814,P＝0．000],术后排气早[（41．0±13．9）h vs．（55．4±15．0）h,t＝-3．219,P＝0．003],但清扫盆腹腔淋巴结数量较少[（19．7±8．2）枚vs．（27．5±7．7）枚,t＝-3．170,P＝0．003],术后留置尿管时间较长[（31．8±23．4） d vs．（14．5±4.7）d,t＝3．177,P＝0．005]。失访腹腔镜组13例,开腹组12例,其余17例中位随访时间53个月（53～107个月）,肿瘤复发率差异无显著性[0（0／8） vs．11．1％（1／9）,P＝1．000]。结论腹腔镜早期宫颈癌根治手术是安全可行的,在严格把握手术适应证的情况下,可替代开腹手术。腹腔镜手术还具有术中失血少、术后恢复快等优势。经过中期随访观察,效果满意。     

腹腔镜辅助小切口宫颈癌根治术临床研究

目的探讨腹腔镜辅助小切口宫颈癌根治术的可行性。方法 2009年1月～2010年7月,施行宫颈癌根治术24例,其中开腹13例,腹腔镜辅助小切口11例。2组年龄、术前分期差异无显著性（P〉0.05）。比较2组手术时间、术中出血量、切除淋巴结数量、术后恢复情况及手术并发症。结果 2组均顺利完成手术。与开腹组相比,腹腔镜辅助组清扫淋巴结数量差异无显著性[（24.5±5.5）个vs.（26.1±3.9）个,t=-0.807,P=0.428],术中出血量少[（296.7±42.1）ml vs.（594.4±87.7）ml,t=-10.878,P=0.000],术后排气时间早[（1.9±0.4）d vs.（2.8±0.6）d,t=-4.386,P=0.000],下床活动时间早[（2.1±0.5）d vs.（3.6±0.7）d,t=-6.110,P=0.000],术后住院时间短[（12.2±3.3）d vs.（17.6±4.8）d,t=-3.254,P=0.004],但手术时间长[（233.2±23.5）min vs.（215.6±11.9）min,t=2.247,P=0.035]。结论腹腔镜辅助小切口宫颈癌根治术出血少,术后恢复快,安全可行。     

腹腔镜下广泛子宫切除加淋巴结清扫术治疗子宫恶性肿瘤42例分析

目的探讨腹腔镜广泛子宫切除加淋巴结清扫术治疗子宫恶性肿瘤的可行性及临床效果。方法回顾分析2007年3月～2011年12月42例腹腔镜手术与同期46例开腹手术行子宫广泛切除、淋巴结清扫治疗的子宫恶性肿瘤的临床资料,比较2组的术中、术后情况。结果与开腹组相比,腹腔镜组术中出血量少[(303.4±118.2)ml vs.(407.6±120.2)ml,t=-4.094,P=0.000],切除淋巴结多[(27.5±5.1)个vs.(20.6±4.3)个,t=6.881,P=0.000],术后排气早[(1.5±0.5)d vs.(2.1±0.6)d,t=-5.069,P=0.000];2组手术病理分期、手术时间、术后并发症的发生率差异无显著性。结论腹腔镜下治疗子宫恶性肿瘤创伤小,恢复快,是一种安全有效的手术方法。     

Total Microlaparoscopic Radical Hysterectomy in Early Cervical Cancer

Background and Objective:

In less than 2 decades, laparoscopy has contributed to modification in the management of early cervical cancer patients, and all comparisons between open and laparoscopic-based radical operations showed an identical oncological outcome. The aim of this study is to describe surgical instrumentations and technique to perform total microlaparoscopy radical hysterectomy in early cervical cancer patients and report our preliminary results in terms of operative time and perioperative outcomes.

Methods:

Between January 1, 2012, and March 25, 2012, 4 consecutive early cervical cancer patients were enrolled in this study.

Results:

We performed 3 type B2 and 1 type C1-B2 total microlaparoscopy radical hysterectomy, and in all cases concomitant bilateral salpingo-oophorectomy and pelvic lymphadenectomy were carried out. Median operative time was 165 minutes (range: 155 to 215) (mean: 186), and median estimated blood loss was 30 mL (range: 20 to 50). Median number of pelvic lymph nodes removed was 12 (range: 11 to 15). All procedures were completed without 5-mm port insertion and without conversion. No intraoperative or early postoperative complications were reported.

Conclusions:

This report suggests a role of microlaparoscopy in the surgical management of early cervical cancer with adequate oncological results, superimposable operative time, and perioperative outcomes with respect to standard laparoscopy.     

腹腔镜下广泛子宫切除、盆腔淋巴结清扫术治疗子宫恶性肿瘤

目的探讨腹腔镜广泛子宫切除、盆腔淋巴结清扫术治疗子宫恶性肿瘤的可行性及临床效果。方法比较2007年3月～2008年3月11例腹腔镜手术与同期26例开腹手术行广泛子宫切除、盆腔淋巴结清扫治疗的子宫内膜癌、子宫颈癌的临床资料,观察2组手术时间、术中出血量、淋巴结切除数量、术后病率、肠道排气时间、住院日等。结果腹腔镜组子宫内膜腺癌3例（ⅠB期2例,ⅡA期1例）,子宫颈鳞癌8例（ⅠA期1例,ⅠB期5例,ⅡA期2例）;开腹组子宫内膜腺癌7例（ⅠB期5例,ⅡA期2例）,子宫颈鳞癌19例（ⅠA期2例,ⅠB期14例,ⅡA期3例）。2组差异无显著性（P〉0．05）。与开腹组相比,腹腔镜组术中出血量少[（216．8±125．4）ml vs（402．1±135．2）ml,t=-3．889,P=0．000],切除淋巴结多[（19．9±6．5）个vs（14．6±5．6）个,t=2．510,P=0．017],术后排气早[（34．6±6．5）h vs（56．4±7．6）h,t=-8．300,P=0．000],住院时间短[（14．6±3．5）d vs（19．4±5．6）d,t=-2．622,P=0．013];2组手术时间、术后病率、尿潴留的发生率差异无显著性（P〉0．05）。2组分别随访（11．0±3．2）和（12．0±2．8）月,无复发证据。结论腹腔镜下治疗子宫恶性肿瘤创伤小,恢复快,是一种安全有效的手术方法。     

微创型举宫器在腹腔镜下保留盆腔自主神经广泛性子宫切除术中的应用

目的探讨微创型举宫器在腹腔镜下保留盆腔自主神经的广泛性子宫切除术（laparoscopic nerve-sparing radicalhysterectomy,LNSRH）中的临床应用价值。方法 2009年l月～2011年4月,使用微创型举宫器对20例ⅠB～ⅡA期宫颈癌及10例Ⅱ期子宫内膜癌行LNSRH。插尿管后置入举宫器,整个手术过程在腔镜下完成,离断阴道后用举宫器将子宫从阴道拖出。结果手术均获成功,术中无泌尿系损伤。手术时间250～340 min,平均270 min;出血量为50～200 ml,平均110ml;术后拔除尿管时间7～17 d,平均10 d。30例术后随访3～30个月,平均16.7月,所有患者健在,无淋巴囊肿,无肿瘤复发、转移,阴道残端均愈合良好。结论 微创型举宫器有操控简单、能配合高难度妇科腔镜手术、使用过程符合无瘤原则、使用成本低的特点,是行LNSRH的理想手术器械。     

Videolaparoscopic Radical Hysterectomy Approach: a Ten-Year Experience

Background:

Because of the advancements in surgical techniques and laparoscopic instruments, total laparoscopic radical hysterectomy can now be performed for the treatment of uterine cervical carcinoma. We assessed the feasibility, complications, and survival rates of patients who underwent total laparoscopic radical hysterectomy with pelvic lymphadenectomy.

Methods:

We retrospectively collected data from the medical charts of 29 patients who had undergone surgery between 1998 and 2008. The following data were assessed: age, staging, histological type, number of lymph nodes retrieved, parametrial measures, operative time, length of hospital stay, surgical complications, and disease-free time.

Results:

The mean patient age was 37.07±10.45 years. Forty percent of the patients had previously undergone abdominal or pelvic surgeries. Mean operative time was 228.96±60.41 minutes, and mean retrieved lymph nodes was 16.9±8.12. All patients had free margins. No conversions to laparotomy were necessary. Median time until hospital dismissal was 6.5 days (range 3–38 days). Four patients had intraoperative complications: 2 lacerations of the rectum, 1 laceration of the bladder, and 1 lesion of the ureter. Three patients developed bladder or ureteral fistulas postoperatively that were successfully corrected surgically.

Conclusion:

Laparoscopic radical hysterectomy is feasible and has acceptable complications. The radicalism of the surgery must be considered, bearing in mind the parametrial measures and the number of lymph nodes retrieved.     

腹腔镜辅助阴式与开腹广泛子宫切除术治疗早期宫颈癌的比较

目的 探讨腹腔镜辅助阴式广泛子宫切除联合盆腔淋巴结清扫术治疗早期宫颈癌的临床效果.方法 回顾性分析我院2005年6月～2011年12月146例临床资料完整的Ⅰ a2～Ⅱb期宫颈癌,83例腹腔镜辅助阴式广泛子宫切除联合盆腔淋巴结清扫术设为研究组,63例开腹广泛子宫切除联合盆腔淋巴结清扫术设为对照组,比较2组手术时间、术中出血量、切除淋巴结数量、术后镇痛药应用、术后排气时间、体温恢复正常时间、拔除盆腔引流管时间、手术并发症、术后生存情况等.结果 与对照组比较,研究组术中出血少[(283.3±162.3) ml vs.(372.9±194.5) ml,t=-3.032,P=0.003]、术后应用镇痛药例数少[15例vs.57例,x2=75.116,P=0.000]、术后排气早[(39.1 ±17.5)h vs.(48.3±19.4)h,t=-3.002,P=0.003]、体温恢复正常快[(47.5±19.7)h vs.(56.1±23.2)h,t=-2.419,P=0.017]、拔除盆腔引流管早[(3.6±1.6)d vs.(4.4±2.7)d,t=-2.090,P=0.039].2组在手术时间[(227.3 ±62.5)min vs.(235.1±67.7)min,t=-0.721,P=0.472]、切除淋巴结数[(22.6±5.7)枚vs.(20.7±6.4)枚,t=1.892,P=0.061]、并发症发生率[41.0％ (34/83) vs.57.1％ (36/63),x2=3.756,P=0.053]及术后复发率[13.2％(11/83) vs.14.3％(9/63),x2=0.032,P=0.857]比较无统计学差异.截止2012年5月30日,研究组83例术后平均随访63.4月(5～77个月),对照组63例术后平均随访62.3月(9～ 79个月),2组术后生存率比较无统计学差异(x2=0.026,P=0.872).结论 腹腔镜辅助阴式广泛子宫切除术创伤小,术后恢复快,近、远期疗效好,是治疗早期宫颈癌安全有效的手术方法.     

Feasibility, Safety, and Cost Outcomes of Laparoscopic Management of Early Endometrial and Cervical Malignancy

Background:

The role of laparoscopy in the management of early stage endometrial and cervical cancer is continuously validated by many reports throughout the world. Interestingly, such data are still unavailable in many European countries, as it is in Greece. In this prospective study, we report on initial feasibility, safety, and cost outcomes of laparoscopic management of early stage endometrial and cervical cancer, recently introduced in our country.

Materials and Methods:

This was a prospective pilot study comprising a case series. Patients referred to a tertiary referral medical center with a recent diagnosis of endometrial or cervical cancer were evaluated, and those meeting inclusion criteria were offered laparoscopic surgical staging.

Results:

Out of 64 patients evaluated, 17 with early clinical stage endometrial cancer and 8 with early clinical stage cervical cancer underwent successful laparoscopic staging. Mean patient age was 61.6 and 39.2 years, mean BMI was 32.3 and 24.1kg/m², mean operative time was 243 and 284 minutes, mean estimated blood loss was 190mL and 270mL, mean lymph node count was 27.2 and 29.1, and mean hospital stay was 2 and 3 days for endometrial and cervical cancer cases, respectively. The overall costs for the procedures performed were not greater than their laparotomy counterpart. One intraoperative complication was managed laparoscopically, and 2 cases occurred of postoperative lymphocyst formation.

Conclusion:

To our knowledge, this is the first study of laparoscopic management of early endometrial and cervical cancer in Greece. Our preliminary data support the feasibility, safety, and cost effectiveness of laparoscopic management of early endometrial and cervical cancer in our country and are in accordance with series reported in the international literature.     

Total Laparoscopic Radical Hysterectomy Versus Abdominal Radical Hysterectomy with Lymphadenectomy in Patients with Early Cervical Cancer: Our Experience

Background  The aim of this study was to retrospectively compare, in a series of 127 consecutive women, the safety, morbidity, and recurrence rate of total laparoscopic radical hysterectomy (TLRH) with lymphadenectomy and abdominal radical hysterectomy with lymphadenectomy (ARH) for early cervical carcinoma. Methods  A total of 127 consecutive patients with International Federation of Gynecology and Obstetrics stage Ia1 (lymphvascular space involvement), Ia2, and Ib1 early cervical cancer, 65 of whom underwent TLRH and 62 of whom underwent ARH with pelvic lymph node dissection, comprised the study population. The para-aortic lymphadenectomy with the superior border of the dissection being the inferior mesenteric artery was performed in all cases with positive pelvic lymph nodes discovered at frozen section evaluation. Results  The median blood loss in the ARH group (145 ml; range, 60–225 ml) was significantly greater than TLRH group (55 ml; range, 30–80 ml) (P < .01). The median length of hospital stay was significantly greater in the ARH group (7 days; range, 5–9 days) than TLRH group (4 days; range, 3–7 days) (P < .01). The median operating time was 196 min in the TLRH group (range, 182–240 min) compared with 152 min in the ARH group (range, 161–240 min) (P < .01). No statistically significant difference was found between the two groups when the recurrence rate was compared. Conclusions   Total laparoscopic radical hysterectomy is a safe and effective therapeutic procedure for management of early-stage cervical cancer with a far lower morbidity than reported for the open approach and is characterized by far less blood loss and shorter postoperative hospitalization time, although multicenter randomized clinical trials with longer follow-up are necessary to evaluate the overall oncologic outcomes of this procedure.     

腹腔镜下系统保留盆腔自主神经的广泛性子宫切除术的比较研究

目的探讨腹腔镜下广泛性子宫切除术（laparoscopic radical hysterectomy,LRH）中系统保留盆腔自主神经（pelvic autonomic nerve,PAN）对膀胱功能恢复的影响。方法 2008年10月～2009年10月42例LRH（宫颈癌ⅠA2～ⅠB1 26例,子宫内膜癌ⅠB～ⅡA 16例）,系统保留PAN 10例（保留PAN组）,32例常规LRH（常规组）,比较2种术式术后膀胱功能的恢复情况。结果所有手术均镜下完成,保留PAN组成功保留单侧PAN 4例,保留双侧PAN 5例,失败1例。保留PAN组术后膀胱功能恢复正常时间（9.2±4.6）d,与常规组（15.2±2.3）d相比明显缩短（t=-5.440,P=0.000）。保留PAN组2例拔尿管后出现尿频、尿痛,常规组有9例。术后切除标本阴道残端、USL、CL长度均〉3 cm,切缘均未出现癌细胞的情况。结论腹腔镜下保留PAN的广泛性子宫切除术,可促进膀胱功能恢复,但远期临床效果还有待观察。     

Robotics Versus Laparoscopic Radical Hysterectomy with Lymphadenectomy in Patients with Early Cervical Cancer: A Multicenter Study

Background  

The aim of this study was to retrospectively compare the safety, morbidity, and recurrence rate of total laparoscopic radical hysterectomy (TLRH) with lymphadenectomy and total robotic radical hysterectomy (RRH) with lymphadenectomy for early cervical carcinoma in a series of 99 consecutive women.     

腹腔镜前列腺癌根治术(附21例报告)

目的探讨腹腔镜前列腺癌根治术的手术技巧和疗效。方法 2005年3月～2008年9月,经腹腔途径行腹腔镜前列腺癌根治术21例(T1a3例,T1b4例,T2a6例,T2b8例),游离膀胱前间隙、盆筋膜,显露前列腺尖部,缝扎阴茎背静脉复合体后离断膀胱颈,游离切除精囊,重建膀胱颈并与尿道吻合。结果 19例手术获得成功,中转开放手术2例,其中阴茎背静脉复合体损伤1例,直肠损伤1例。手术时间155～450min,平均280min;术中出血量170～2500ml,平均470ml。术后病理报告切缘阳性1例。术后尿管留置10～40d,平均14d,无真性尿失禁发生。术后发生漏尿3例,尿道狭窄1例,均治愈。21例随访5～44个月,平均18.5月,PSA0～5.85ng/ml,平均0.23ng/ml,未发现局部复发和远处转移。结论腹腔镜前列腺癌根治术是治疗局限性前列腺癌的安全有效措施。熟练掌握盆腔解剖,预先处理阴茎背静脉复合体,膀胱颈重建和镜下吻合技术是成功实施手术的关键。     

腹腔镜下保留盆腔神经功能的宫颈癌根治术近期疗效的比较研究

目的探讨腹腔镜下保留盆腔神经丛的根治性子宫切除术(laparoscopic nerve-sparing radical hysterectomy,LNSRH)的可行性、安全性。方法 2009年2月~2010年4月对87例腹腔镜下宫颈癌根治术进行了前瞻性非随机对照研究,其中LNSRH组41例,腹腔镜下根治性子宫切除(laparoscopic radical hysterectomy,LRH)46例(LRH组),比较2组手术时间、出血量、清扫淋巴结数及术后膀胱功能恢复等。结果 2组均顺利完成手术,2组术中出血量、淋巴结清扫数目、阴道和宫旁切除长度上无明显差异(P=0.233,0.309,0.310,0.075)。LNSRH组手术时间(151.1±19.2)min显著长于LRH组(124.3±24.4)min(t=5.645,P=0.000)。LNSRH组尿潴留2例,LRH组8例,2组尿潴留发生率无统计学差异(χ2=2.220,P=0.136)。2组84例随访2~14个月,均存活,LNSRH组无复发,LRH组复发1例。结论 LNSRH治疗早期宫颈癌安全可行。     

腹腔镜进展期胃癌根治术66例报告

目的探讨腹腔镜进展期胃癌根治术的安全性及可行性。方法 2006年4月-2010年6月对66例进展期胃癌行腹腔镜胃癌根治术,其中远端胃癌根治性切除术41例;近端胃癌根治性切除术22例,全胃癌根治性切除术3例。结果 66例手术均获成功。手术时间：远端胃癌根治术平均280 min（220-340 min）;近端胃癌根治术平均269 min（215-325min）;3例根治性全胃切除术手术时间分别为340、370、410 min。平均切口长度6.0 cm（5.2-9.0 cm）。术中出血量：腹腔镜远端胃癌根治术平均160 ml（100-250 ml）,腹腔镜近端胃癌根治术平均200 ml（90-320 ml）,3例腹腔镜根治性全胃切除术出血量分别为200、350、400 ml。清扫淋巴结：远端胃癌根治术平均21枚（15-31枚）,近端胃癌根治术平均22枚（17-28枚）,3例根治性全胃切除术分别为25、29、35枚。65例术后随访3-48个月,平均20个月（〈1年21例,1-2年19例,〉2年25例）,均未见切口及戳孔肿瘤种植转移;1例ⅢB期术后1年出现腹腔种植转移后死亡,1例ⅢB期术后1年出现肝转移后死亡,其余患者均健在。结论腹腔镜进展期胃癌根治术安全可行,能够取得良好的近期疗效。     

腹腔镜远端胃癌D_2根治术手术路径的临床应用研究

目的探讨腹腔镜远端胃癌D2根治术手术路径的临床效果。方法 2007年10月-2010年5月,对56例远端胃癌实施腹腔镜远端胃癌D2根治手术。手术路径：大网膜切除和横结肠系膜前叶剥离;解剖腹腔动脉、肝总动脉、脾动脉及清扫相应淋巴结;处理胃右动脉和5组淋巴结;清扫12a组淋巴结等顺序进行,淋巴清扫以4d→4sb→14v→6→7/9→11p→8a→5→12a→1→3的路径进行。结果手术时间130-375 min,（203.4±48.4）min。清扫淋巴结13-21枚,（16.2±1.2）枚。术后胃肠功能恢复时间48-120 h,（80.6±17.7）h。标本远近切缘无癌残留。无围手术期死亡病例。术后72 h吻合口出血1例,96 h输出端梗阻1例。56例术后随访2-31个月,（14.1±6.9）月,死亡8例：肿瘤广泛转移6例,心脑血管疾病2例;带瘤生存5例,无瘤生存43例,无瘤生存时间最长已31个月。结论腹腔镜远端胃癌D2根治术按照合理的路径进行手术,能够保证手术在正确的间隙和解剖层面进行,有利于在遵循肿瘤根治的原则下完成手术。     

腹腔镜下保留盆腔神经的广泛子宫切除术对膀胱功能的保护效果

目的：客观评价腹腔镜下保留盆腔神经的广泛子宫切除术对膀胱功能的保护效果。方法2009年2月～2011年8月,对43例Ⅰa2～Ⅱa期宫颈癌及24例Ⅱ期子宫内膜癌行腹腔镜下保留盆腔神经的广泛子宫切除术（ laparoscopic nerve-sparing radical hysterectomy ,LNSRH）,术前及术后1、6、9、12个月行尿动力学检查,包括尿道测压、膀胱压力容积测定及尿流率测定。结果手术均获成功。手术时间250～310 min,平均260 min;术中出血量50～150 ml,平均80 ml;阴道切除长度3．1～4．3 cm,平均3．5 cm;主韧带切除长度3．0～4．2 cm,平均3．3 cm;宫骶韧带切除长度3．2～3．9 cm,平均3．5 cm。64例术后7 d拔除尿管,残余尿量＜50 ml;3例术后7 d残余尿量＞100 ml,术后14 d恢复至＜50 ml。67例完成术前、术后尿动力学检查,差异均无显著性。术后随访12～44个月,平均35个月,无淋巴囊肿及肿瘤复发、转移,阴道残端均愈合良好。结论 LNSRH安全可行,既能保证疗效,又保证了患者的生活质量。     

腹腔镜前列腺癌根治术

目的总结腹腔镜前列腺癌根治术的经验。方法2004年9月～2005年12月,我科对8例早期局限性前列腺癌行经腹腔腹腔镜前列腺癌根治术,游离前列腺直肠间隙达前列腺尖部,游离膀胱前间隙及耻骨后间隙,缝扎阴茎背深静脉后离断膀胱颈部,重建膀胱颈并与尿道吻合。结果8例腹腔镜前列腺癌根治术均获成功,无一例中转开放手术。手术时间270～420min,平均325min;术中出血量300～1600ml,平均580ml,其中1例由于术中损伤阴茎背深静脉大出血1600ml,需要输血4例。标本切缘阳性1例。术后膀胱尿道吻合口尿漏2例;术后2周拔除导尿管,出现尿失禁2例,1例尿失禁在随访6个月后尿控能力恢复,另1例尿失禁仍存在。8例术后随访10～24个月,平均16个月,排尿均通畅,未出现生化复发现象。结论熟悉前列腺的局部解剖、有良好的腹腔镜器械辅助及熟悉掌握各种腹腔镜下操作技术是开展此手术的关键。     

卡孕栓与新斯的明治疗宫颈癌根治术后尿潴留的疗效比较

目的对比卡孕栓与新斯的明治疗宫颈癌根治性子宫全切除术后尿潴留的疗效。方法选取2008年1月～2011年3月宫颈癌根治性子宫全切除术后发生尿潴留的患者52例。随机分为实验组及对照组各26例。实验组舌下含服卡孕栓1mg,对照组经臀部肌注新斯的明1mg,比较两组患者用药60min后的效果。结果实验组效果明显优于对照组,两组差异有统计学意义（P〈0.05）。结论卡孕栓治疗宫颈癌根治术后的尿潴留疗效迅速,效果显著。     

子宫颈癌根治术后并发症分析（附300例报告）

目的探讨子宫颈癌根治术后并发症及其预防措施。方法回顾性分析2002年1月至2007年1月收治的300例子宫颈癌根治术患者的临床资料,其中未保护盆腔自主神经者181例,术前辅助化疗128例,术前放疗102例。结果本组术后并发症发生率为28.3%（85/300）,其中尿潴留44例（14.7%）,盆腔淋巴囊肿29例（9.7%）,腹壁切口5例（1.7%）,阴道残端出血3例（1.0%）,输尿管瘘2例（0.7%）,肺部感染1例（0.3%）,下肢静脉栓塞1例（0.3%）。术前辅助化疗者并发症发生率为29.7%（38/128）,未行辅助化疗者为27.3%（47/172）,两者比较无统计学差异（P〉0.05） 术前辅助放疗和未行放疗者并发症发生率分别为29.4%（30/102）和27.8%（55/198）,两者比较无统计学差异（P〉0.05） 保留盆腔自主神经和未保留盆腔自主神经患者术后排尿功能障碍发生率分别为4.2%（5/119）和21.5%（39/181）,两者比较具有显著统计学差异（P〈0.05）。结论保留盆腔植物神经的子宫颈癌根治术可减少排尿功能障碍发生,术前新辅助放化疗与否对其并发症发生无影响。