腹腔镜广泛子宫切除及盆腔淋巴结清扫术治疗早期宫颈癌183例临床分析

目的：探讨腹腔镜下广泛子宫切除及盆腔淋巴结清扫术治疗早期宫颈癌的安全性、有效性、临床效果及并发症.方法：回顾性分析183例腹腔镜下广泛子宫切除及盆腔淋巴结清扫术治疗早期宫颈癌患者的临床资料.并与同期30例开腹行广泛性子宫切除及盆腔淋巴结清扫治疗早期宫颈癌作对照研究.结果：腹腔镜组手术平均时间明显长于开腹手术组（P＜0.05）,术中出血量、胃肠功能恢复时间、术后住院时间明显少于剖腹手术组（P＜0.05）,术中无邻近脏器损伤发生,切除的淋巴结数均无显著性差异（P＞0.05）.腹腔镜组162例获得随访,平均随访（12.8±6.9）月,并发症发生率为14.81％ （24/162）,开腹组28例获得随访,平均随访（13.2±5.9）月,并发症发生率为17.8％（5/28）,两组并发症发生率差异无统计学意义.结论：腹腔镜下广泛全子宫切除加盆腔淋巴结清扫术治疗早期宫颈癌临床效果肯定,与开腹手术治愈率相近,具有创伤小,恢复快,并发症发生率低等优势.

Clinical report of 183 cases undergoing laparoscopic radical hysterectomia and pelvic lymphadenectomy for early uterine cervix cancer

Objective：To study the clinical value and therapeutic effect of laparoscopic radical hysterectomy and pelvic lymphadenectomy for uterine cervix cancer. Methods：All 183 patients laparoscopic surgical under the extensive hysterectomy parallel pelvic lymph node dissection and removing the tumor invasion and tissues transfer by laparo- scopic radical hysterectomy and pelviclymphadeneetomy. The 183 patients clinical data was retrospectively studied. Results：All the 183 cases were successfully performed by laparoscopic radical hysterectomy and pelvic lymphadenec- tomy with no transferred to opening laparotomy surgery. The operating time was （ 147 ~ 31.6） minutes, blood loss in op- eration was （185 ~ 56.1 ）ml. The median number of harvested lymph nodes was （21.3 ~ 4.2 ）. Requiring no blood transfusion and no organ damages were found in all cases, and operation complication was 14.81% （24/162） in six months in the follow -up. Conclusion：Laparoscopic radical hystectomy and plevic lymphadenectomy can be realized as treatment for early cervix cancer, they have a quick postoperative recovery, with small trauma, faster recovery ,lower complication rate.