腹腔镜下保留盆腔神经功能的宫颈癌根治术近期疗效的比较研究

目的探讨腹腔镜下保留盆腔神经丛的根治性子宫切除术(laparoscopic nerve-sparing radical hysterectomy,LNSRH)的可行性、安全性。方法 2009年2月~2010年4月对87例腹腔镜下宫颈癌根治术进行了前瞻性非随机对照研究,其中LNSRH组41例,腹腔镜下根治性子宫切除(laparoscopic radical hysterectomy,LRH)46例(LRH组),比较2组手术时间、出血量、清扫淋巴结数及术后膀胱功能恢复等。结果 2组均顺利完成手术,2组术中出血量、淋巴结清扫数目、阴道和宫旁切除长度上无明显差异(P=0.233,0.309,0.310,0.075)。LNSRH组手术时间(151.1±19.2)min显著长于LRH组(124.3±24.4)min(t=5.645,P=0.000)。LNSRH组尿潴留2例,LRH组8例,2组尿潴留发生率无统计学差异(χ2=2.220,P=0.136)。2组84例随访2~14个月,均存活,LNSRH组无复发,LRH组复发1例。结论 LNSRH治疗早期宫颈癌安全可行。

Short-term Efficacy of Laparoscopic Nerve-Sparing Radical Hysterectomy

Objective To investigate the feasibility and safety of bladder laparoscopic nerve-sparing radical hysterectomy（LNSRH）.Methods Between February 2009 and April 2010,we carried out prospective non-randomized control study on 87 postoperative patients with cervical cancer in Xinjiang Tumor Hospital,the patients were divided into LNSRH group（41 cases）and laparoscopic radical hysterectomy（LRH）group（46 cases）.Operation time,intraoperative blood loss,number of dissected lymph nodes,and recovery of bladder function after the surgery were compared between the two groups.Results The operations were completed successfully in all the 87 patients.No significant difference was detected between the two groups in terms of intraoperative blood loss,number of dissected lymph node,length of resected vagina and paracervical tissues（P=0.233,0.309,0.310,and 0.075,respectively）.Whereas,LNSRH group had significantly longer operation time [（151.1±19.2）min vs（124.3±24.4）min,t=5.645,P=0.000].After the operation,2 patients from the LNSRH group,and 8 patients from the LRH group developed urine retention（χ2=2.220,P=0.136）.Follow-up was achieved in 84 patients for 2 to 14 months,all of them survived,only one patient who received LRH had relapse.Conclusion LNSRH is safe and feasible in the treatment of early cervical cancer.