免举宫器改良腹腔镜根治术在早期子宫颈癌中的临床应用价值OA北大核心CSTPCD
The Clinical Application Value of Modified Laparoscopic Radical Surgery with-out Uterine Manipulator in Early Cervical Cancer
目的:探究免举宫器改良腹腔镜根治术在治疗早期子宫颈癌中的临床应用价值.方法:选取2019 年1 月至2020 年1 月在四川大学华西第二医院就诊的105 例早期子宫颈癌(ⅠB1、ⅠB2、ⅡA1 期)患者的临床资料进行回顾性分析,根据手术方式不同分为免举宫器组(35 例)、安置举宫器组(35 例)及开腹组(35 例),比较3 组患者手术时长、术中出血量、切除淋巴结数目、术后肛门排气时间、引流管安置时间、住院时间、手术并发症发生率、复发率及死亡率等指标.结果:3 组患者比较,淋巴结切除数、术后肛门排气时间、引流管安置时间、住院时间差异无统计学意义(P>0.05).两两组间比较,免举宫器组手术时长长于开腹组,开腹组术中出血量和术后肛门排气时间均多于其他两组,差异均有统计学意义(P<0.05).3 组患者发生手术并发症共18 例,免举宫器组、开腹组、安置举宫器组发生率分别11.4%、20.0%、20.0%,差异无统计学意义(P>0.05).术后2 年复发肿瘤患者共8 例,免举宫器组、开腹组及安置举宫器组复发率分别为 0、5.7%、17.1%,差异有统计学意义(P<0.05),且免举宫器组复发率明显低于安置举宫器组,差异有统计学意义(P<0.05).术后2 年内死亡患者免举宫器组0 例,开腹组 0 例,安置举宫器组 1 例,差异无统计学意义(P>0.05).结论:免举宫器改良腹腔镜根治术可降低安置举宫器腹腔镜根治术的肿瘤复发风险,与开腹手术治疗效果相当,且不增加手术并发症风险,具有临床运用价值.
Objective:To explore the clinical value of modified laparoscopic radical surgery without uterine ma-nipulator in the treatment of early cervical cancer.Methods:A retrospective analysis was conducted on the clinical data of 105 patients with early cervical cancer(stages ⅠB1,ⅠB2,ⅡA1)who underwent radical resection of cer-vical cancer in West China Second University Hospital,Sichuan University from January 2019 to January 2020.According to the operation methods,the patients were divided into uterine lifter-free group(35 cases),uterine lifter group(35 cases)and laparotomy group(35 cases).The operation duration,intraoperative blood loss,number of resected lymph nodes,postoperative anal exhaust time,drainage tube placement time,hospitalization time,inci-dence of surgical complications,recurrence rate and mortality rate were compared among the three groups.Re-sults:There was no statistically significant difference in the number of lymph node resection,the postoperative anal exhaust time,drainage tube placement time and hospitalization time among the three groups(P>0.05).Comparison between two groups showed that the operation time of the group without uterine lifting was longer than that of the laparotomy group,and the intraoperative bleeding volume and the Postoperative anal exhaust time of the laparotomy group were more than those of the other two groups,and the differences were statistically signif-icant(P<0.05).There were 18 cases of surgical complications in the three groups.The incidence rate of uterine lifter-free group,laparotomy group and uterine lifter group was 11.4%,20.0%and 20.0%,respectively,with no statistically significant difference(P>0.05).There were 8 patients with recurrence 2 years after operation,the re-currence rates of the uterine lifter-free group,the laparotomy group and the uterine lifter group were 0,5.7%and 17.1%,respectively,the difference was statistically significant(P<0.05).The recurrence rate of the group with-out uterine lifting was significantly lower than that of the uterine lifting group(P<0.05).There were0 death in the non-lifting group,0 in the laparotomy group,and 1 case in the uterine lifting device group within 2 years after oper-ation,the difference was no statistically significant(P>0.05).Conclusions:The modified laparoscopic radical re-section without uterine lifter can reduce the risk of tumor recurrence in laparoscopic radical resection with uterine lifter,which is equivalent to the treatment effect of open surgery,and does not increase the risk of surgical compli-cations.It has clinical application value.
李佳容;刘辉
四川大学华西第二医院妇产科,四川 成都 610044
临床医学
子宫颈癌免举宫器改良腹腔镜根治术应用价值
Cervical cancerWithout uterine manipulatorModified laparoscopic radical surgeryApplication value
《实用妇产科杂志》 2024 (003)
225-229 / 5
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