两种广泛性子宫切除术治疗早期子宫颈癌的疗效比较

目的:比较腹腔镜与开腹广泛性子宫切除术治疗早期子宫颈癌的疗效。方法:选择2005年7月～2008年12月期间在六盘水市妇女儿童医院行广泛性子宫切除术的早期子宫颈癌患者137例,按手术方式分为两组,观察组85例接受腹腔镜广泛性子宫切除术治疗;对照组52例接受开腹广泛性子宫切除术治疗。术后对患者进行长达3年的随访,记录患者的生存情况。结果:①观察组手术时间显著长于对照组(P<0.05),术中出血量显著少于对照组(P<0.05);两组患者盆腔淋巴结清除数目、阴道切除长度、宫旁组织切除长度相比差异无统计学意义(P>0.05)。②观察组术后肛门排气时间、术后排尿功能恢复时间显著短于对照组,术后并发症发生率显著低于对照组(P<0.05)。③两组患者的复发率、1年生存率、3年生存率、术后生活质量评分相比差异无统计学意义(P>0.05)。结论:腹腔镜与开腹广泛性子宫切除术治疗早期子宫颈癌的远期疗效相近,但是腹腔镜广泛性子宫切除术具有术中出血量少、术后恢复快、并发症发生率低等优点,因此该术式是治疗早期宫颈癌的一种理想术式。

Comparison of curative effects of two kinds of radical hysterectomy for treatment of early stage cervical cancer

Objective:To compare the curative effects of laparoscopic radical hysterectomy and laparotomy of radical hysterectomy for treatment of early stage cervical cancer.Methods:A total of 137 patients with early stage cervical cancer who underwent radical hysterectomy in the hospital from July 2005 to December 2008 were selected and divided into two groups according to different surgical methods,85 patients in observation group underwent laparoscopic radical hysterectomy,while 52 patients in control group underwent laparotomy of radical hysterectomy.All the patients were followed up for three groups after treatment,the survival conditions of the patients in the two groups were recorded.Results:The operation time in observation group was statistically significantly longer than that in control group(P<0.05).The amount of blood loss during operation in observation group was statistically significantly less than that in control group(P<0.05).There was no statistically significant difference in the number of excised lymph nodes,the length of excised vagina,and the length of excised parametrium between the two groups(P>0.05).The anal exhausting time and recovery time of urinary function after surgery in observation group were statistically significantly shorter than those in control group,the incidences of postoperative complications in observation group were statistically significantly lower than those in control group(P<0.05).There was no statistically significant difference in the recurrence rate,one-year survival rate,three-year survival rate,and postoperative score of quality of life between the two groups(P>0.05).Conclusion:The long-term curative effects of laparoscopic radical hysterectomy and laparotomy of radical hysterectomy for treatment of early stage cervical cancer were similar,but laparoscopic radical hysterectomy had the advantages of less intraoperative blood loss,quicker postoperative recovery,and lower incidence of postoperative complications,so the method is an optimal surgery for treatment of early stage cervical cancer.