阴式广泛全子宫切除加腹腔镜下淋巴结切除术与开腹手术治疗早期宫颈癌疗效比较

目的探讨阴式广泛全子宫切除加腹腔镜下淋巴结切除术治疗早期宫颈癌的临床价值。方法 2004年11月至2011年4月于佛山市妇幼保健院,回顾性分析行阴式广泛全子宫切除加腹腔镜下淋巴结切除术的90例早期宫颈癌患者(阴式组)的病例资料,抽取同期行开腹广泛全子宫切除加盆腔淋巴结切除术42例(开腹组)作为对照。结果两组手术时间差异无统计学意义(P>0.05)。阴式组术中出血量[(348±114)mL]、肠道功能恢复时间[(36.76±4.9)h]、住院天数[(10.56±2.10)d]均少于开腹组的[(398±127)mL]、[(40.09±6.5)h]、[(11.79±2.45)d],差异有统计学意义(P<0.05)。阴式组切除阴道长度[(3.12±0.17)cm]大于开腹组的[(3.05±0.21)cm](P<0.05)。阴式组尿潴留发生率(30.0%)较开腹组(11.9%)高(P<0.05)。阴式组术后5年内复发率(14.6%)低于开腹组(31.5%)(P<0.05)。结论阴式广泛全子宫切除加腹腔镜下淋巴结切除术式创伤小,术后恢复快,手术彻底,有临床应用价值。

Comparative study on laparoscopic pelvic lymphadenectomy assisted radical vaginal hysterectomy and radical hysterectomy plus pelvic lymphadenectomy by laparotomy in treating early-stage cervix cancer

Objective To evaluate the value of laparoscopic pelvic lymphadenectomy assisted radical vaginal hysterectomy(LARVH)in the treatment of early-stage cervix cancer.Methods These retrospective analysis include two groups:90 patients underwent laparoscopic pelvic lymphadenectomy assisted radical vaginal hysterectomy(vaginal group),42 patients were treated with radical hysterectomy plus pelvic lymphadenectomy by laparotomy(laparotomy group).Results The average operation time was(213±20) min in vaginal group and(207±21) min in laparotomy group,P>0.05.Comparing with the patients in laparotomy group,the patients in vaginal group had a less blood loss,shorter interval of postoperative gastrointestinal function recovery,shorter hospital stay,longer resection vaginal length,P<0.05.The urinary retention rate in vaginal group higher than laparotomy group,P< 0.05.The recurrence rate in vaginal group was lower than laparotomy group,P<0.05.Conclusions LARVH may be less invasive,and recovery time may be reduced.It may be a thorough surgery,and has clinical application value.