晚期妇科恶性肿瘤盆腔脏器清除术18例分析

目的 探讨晚期妇科恶性肿瘤盆腔脏器清除术的治疗效果和术后并发症的防治。方法 对晚期宫颈癌８例、外阴癌８例和阴道癌２例施行了盆腔脏器清除术。宫颈癌中Ⅳ期（中央型）５例，其余３例为复发癌；外阴癌中Ⅲ期３例，Ⅳ期５例；阴道癌２例均为Ⅲ期。结果 本组资料的３年生存为７２％，５年生存率为５０％。无术中死亡者。术中出血７００～１２００ｍｌ，术后并发症发生率为１６％。２例肠梗阴，１例手术治疗，１例保守治疗后缓解

Pelvic Exenteration of Advanced Gynecological Malignacies:AReport of 18 Cases

OBJECTIVE: To investigate the role of pelvic exenteration in the treatment of advanced gynecological malignances. METHODS: Eighteen patients with cervical cancer in 8, vulvar cancer in 8, and vaginal cancer in 2, who underwent pelvic exenteration at the Cancer Hospital of Shanghai Medical University between 1970 and 1990 were retrospectively analyzed. RESULT: Median age was 52 years (range 27-65). One woman received surgery of total pelvic exenteration, 10 anterior and 7 posterior exenteration. The 3,5-year survival rates were 72%, 50%, respectively. Postoperative morbidity was 16%, and the surgical mortality was 0%. Bowel obstruction occurred in 2 of 18 cases, one of them was treated surgically. CONCLUSIONS: (1) Patients with advanced central type pelvic neoplasms can be successfully treated with exenteration; (2) The patients should be properly selected prior to and in operation, and the procedures must be performed specifically, particularly in exploration stage.