新辅助化疗联合腹腔镜手术治疗局部晚期宫颈癌

目的评价新辅助化疗结合腹腔镜下广泛全子宫切除、盆腔淋巴结清扫治疗局部晚期宫颈癌（FIGOⅠb2到Ⅱa期）的临床疗效。方法选取2006年9月-2009年12月在我院妇产科治疗的局部晚期宫颈癌（FIGOⅠb2到Ⅱa期）患者86例,新辅助化疗后45例行腹腔镜广泛子宫切除盆腔淋巴结清扫术,41例行经腹广泛子宫切除、盆腔淋巴结清扫术。结果新辅助化疗后总有效率为86.0%,两组间的年龄、分期、病理分级无差异,两组手术效果相当,但腹腔镜组出血少、术后病率低、住院时间短。结论新辅助化疗结合腹腔镜下广泛子宫切除术治疗局部晚期宫颈癌（FIGOⅠb2-Ⅱb期）安全可行的。

Treatment of local advanced cervical cancer with laparoscopic surgery after new adjuvant chemotherapy

Objective To evaluate the curative effect of laparoscopic total hysterectomy and pelvic lymphadenectomy on local advanced cervical cancer after new adjuvant chemotherapy.Methods Of the 86 patients with local advanced cervical cancer admitted to our department from September 2006 to December 2009,45 underwent laparoscopic total hysterectomy and pelvic lymphadenectomy（group A）,41 underwent trans-abdominal massive hysterectomy and pelvic lymphadenectomy（group B）,after new adjuvant chemotherapy.Results The total effective rate of laparoscopic total hysterectomy and pelvic lymphadenectomy was 86.0% for local advanced cervical cancer after new adjuvant chemotherapy,with no significant difference in age of patients,cancer stage and pathological grade between the two groups.The blood loss during operation was less,the incidence of complications after operation was lower,and the hospital stay time was shorter after operation in group A than in group B.Conclusion Laparoscopic total hysterectomy is safe for local advanced cervical cancer after new adjuvant chemotherapy.