早期宫颈癌宫颈广泛性切除术的研究进展

宫颈癌是最常见的妇科恶性肿瘤之一,随着宫颈癌发病群体的年轻化,越来越多的宫颈癌患者有保留生育功能的需求。宫颈广泛性切除术已成为国际妇产科联盟（International Federation of Gynecology and Obstetrics,FIGO）分期ⅠA2期、ⅠB1期宫颈癌患者保留生育功能的标准手术方式,在肿瘤直径>2 cm的新辅助化疗后的宫颈癌患者及妊娠合并宫颈癌患者中也有应用。宫颈广泛性切除术范围广、难度大、手术时间长,术后并发症发生率较高。手术入路、术中操作和淋巴结评估方式都可能对肿瘤预后及妊娠结局产生不同的影响。因此,寻求宫颈广泛性切除术后肿瘤学预后与生育功能之间的平衡,在保证肿瘤切除范围的同时减少不必要的组织切除与损伤,缩短手术时间,降低并发症发生概率,可以使更多接受宫颈广泛性切除术的宫颈癌患者获益。

Research Progress of Radical Trachelectomy for Early Stage Cervical Cancer

Cervical cancer is one of the most common gynecological malignant tumors. With the trend of younger age of cervical cancer, more and more patients have the requirement of sparing fertility. Radical trachelectomy has become the standard surgical method for preserving reproductive function in patients with International Federation of Gynecology and Obstetrics （FIGO） stage ⅠA2 and ⅠB1 cervical cancer,and has also been applied in patients with cervical cancer with tumor diameter >2 cm after neoadjuvant chemo therapy and patients with pregnancy complicated with cervical cancer. Radical trachelectomy has a large operation scope, great difficulty, long operation time and high incidence of postoperative complications. Surgical approach, intraoperative technique and the way of lymph node evaluation may have different effects on tumor prognosis and pregnancy outcome. Therefore, seeking a balance between tumor prognosis and reproductive function after radical trachelectomy, reducing unnecessary tissue resection and injury while ensuring tumor resection scope, shortening operation time and reducing the probability of complications can benefit more cervical cancer patients undergoing radical trachelectomy.