腹腔镜下系统保留盆腔自主神经广泛性子宫切除术的临床观察

目的初步研究腹腔镜下系统保留盆腔自主神经的广泛性子宫切除术（SNSRH）治疗早期宫颈癌的可行性及临床价值。方法选取2011年8月～2013年8月，郑州市第一人民医院对28例Ⅰa～Ⅱa期宫颈癌患者行SNSRH与同期传统的腹腔镜下非保留神的广泛性全子宫切除术对比，分析两组手术时间、术中出血量、手术并发症、术后住院天数及术后膀胱、直肠功能情况。结果（1）保留组与非保留组严格按照Ⅲ型子宫切除标准，手术切除范围差异无统计学意义；（2）成功保留神经24例，失败4例，成功率为86％；（3）两组手术范围、术中出血量差异无统计学意义（P〉0．05）；平均留置尿管天数、术后残余尿量、排气排便时间差异有统计学意义（P〈0．05）。结论腹腔镜下SNSRH具有可行性，有助于术后膀胱、直肠功能的恢复。

Preliminary clinical study of laparoscopic-assisted operation of systematic nerve-sparing radical hysterectomy

Objective To investigate the feasibility and clinical value of laparoscopic-assisted operation of systematic nerve-sparing radical hysterectomy（SNSRH） for cervical cancer patients. Methods 28 cases of Ⅰ a- Ⅱ a cervical cancer patients which were operated by systematic nerve-sparing radical hysterectomy （SNSRH）, compared with group of non-systematic nerve-sparing radical hysterectomy（NSNSRH）, all patients were from Zhengzhou First People＇s Hospital between August 2011and August 2013. These patients were detected by operative time, blood loss, complications, postoperative hospital stay, bladder and bowel function after operations. Results （1）There was no significant difference between the two groups in the extent of resection. Both groups were resected according to the standard of Ⅲ hysterectomy. （2） There were 24 cases of successful retention of SNSRH and four cases of failure, the success ratio of 86%. （3） There was no significantdifference in average operation time and blood loss during the operation between the two groups; There was significant difference in the media duration of postoperative catheterization, the postoperative residual urine volume, the first exhaust time and the first stool time between SNSRH group and NSNSRH group （P 〈 0.05）. Conclusion There was feasibility of Laparoscopic-assisted operation of SNSRH for cervical cancer patients because of better preservation of bladder and bowel function.