腹腔镜下广泛子宫切除术联合盆腔淋巴结切除术治疗宫颈癌213例临床分析

目的]探讨腹腔镜下广泛子宫切除术联合盆腔淋巴结切除术治疗早期宫颈癌的临床疗效。方法]回顾性分析2006年7月至2008年7月213例Ⅰa2～Ⅱb期宫颈癌患者行腹腔镜下广泛性子宫切除术联合盆腔淋巴结切除术的临床资料和随访资料。结果]210例患者在腹腔镜下完成手术,手术时间平均210min,术中出血量平均321ml。切除盆腔淋巴结平均15枚;术后肠道功能恢复时间平均2.5d;术后留置尿管时间平均15.5d。术中并发症18例,术后近期并发症30例：阴道残端感染8例,术后肠梗阻3例,输尿管阴道瘘5例,膀胱阴道瘘4例,6例下肢深静脉栓塞,淋巴囊肿4例。1年生存率为95.4%（203/213）,3年生存率为85.8%（183/213）。结论]腹腔镜下广泛子宫切除术联合盆腔淋巴结切除术治疗宫颈癌安全可行。

Clinical Analysis of Laparoscopic Radical Hysterectomy and Pelvic Lymphadenectomy for 213 Cases with Cervical Cancer

Purpose] To investigate the clinical effect laparoscopic radical hysterectomy and pelvic lymphadenectomy for cervical cancer.Methods] A total of 213 cases with cervical cancer stage Ⅰa 2 ～Ⅱb was treated with laparoscopic radical hysterectomy and pelvic lymphadenectomy from July 2006 to July 2008.The clinical data and follow-up results were also reviewed.Results] Two hundred and ten cases underwent laparoscopic surgery with mean operative time 210min,blood loss 321ml.The average number of pelvic lymph nodes resected was 15,and the mean days of bowel function recovery and indwelling urinary eatheter were 2.5d and 15.5d respectively.The operative complication was found in 18 cases,including 8 cases with vagina infections,3,ileus;5,uretero-vaginal fistula;4,vesico vaginal fistula;6 deep venous thrombosis and 4,lymphocyst.The survival rate of 1-year,3-year was 95.4%(203/213) and 85.8%(183/213) respectively.Conclusions] Laparoscopic radical hysterectomy and pelvic lymphadenectomy are