子宫内膜癌手术范围的前瞻性临床研究

目的探讨子宫内膜癌的适宜手术范围、方法对105例子宫内膜癌患者施行广泛性或次广泛性子宫切除术,加盆腔及(或)腹主动脉旁淋巴结清扫术;另外36例子宫内膜癌患者仅作次广泛子宫切除术。对141例的手术切除标本,包括子宫旁结缔组织及淋巴结、盆腔及腹主动脉旁淋巴结等进行病理学检查。结果 105例子宫内膜癌患者中,盆腔淋巴结发生转移26例,占24．76％。除Ⅰa期外,其余各期均有淋巴结转移发生。Ⅰb、Ⅰc期淋巴结转移率分别为12．50％、21．05％。141例行广泛性或次广泛性子宫切除术者中,宫旁组织转移2例(Ⅱa、Ⅲb期),宫旁淋巴结转移2 例(Ⅰc、Ⅲb期);宫旁血管瘤栓2例(Ⅰb、Ⅰc期)。结论除Ⅰa期以外的其他各期,均宜施行广泛性或次广泛性子宫切除术,以及盆腔和／或腹主动脉旁淋巴结清扫术。

Scope of extended operation for endometrial carcinoma

Objective To investigate the scope of extended operation for endometrial carcinoma. Methods One hundred and five patients underwent extended or less extended hysterectomy plus pelvic and/or para - aortic lymphadenectomy and 36 patients underwent less radical hysterectomy only. Prospective investigation of these 141 cases of endometrial carcinoma were undertaken. Results Of the 105 cases,lymph node metastasis occurred in 26 cases (24.76%). Metastasis -were found in all stages except Ia. The incidences of lymph node metastasis in stage Ib and stage Ic were 24. 76% and 21.05% respectively. Of the 141 cases of extended or less extended hysterectomy ,2 were with parametrial connective tissue metastasis (stage Ⅱ a and stage Ⅲ b),2 with parametrial lymph node metastasis (stage Ⅰc and stage Ⅲ b), and 2 with parametrial vascular involvement (stage Ⅰb aod stage Ic). Conclusion The extended or the less extended hysterectomy and lymphadenectomy should be performed in all patients of endometrial carcinoma except these of stage Ia.