摘要
目的:探讨腹腔镜下根治性子宫切除术治疗早期宫颈癌的近期疗效。方法:纳入2021年9月-2023年12月就诊于本院的FIGO分期为IA1期、IA2期和IB1期宫颈癌患者,按随机数字表法分为腹腔镜下根治性子宫切除术组(腹腔镜组)和开放式根治性子宫切除术组(开放手术组)各60例,比较两组近期手术疗效。结果:两组的手术时间、住院天数、膀胱/输尿管/肠道损伤发生率、淋巴结清扫数量、导尿管和引流管保留天数、术后并发症发生率、盆腔灌洗液细胞学阳性占比、阴道边缘病理阳性占比均无统计学差异(P>0.05)。腹腔镜组的阴道残端闭合时间为(9.7±0.3)min,显著低于开放手术组的(13.5±0.4)min(P<0.05);腹腔镜组的术中失血量为(251.4±23.1)ml,显著低于开放手术组的(296.7±26.6)ml(P<0.05),腹腔镜组术中输血占比低于开放手术组(P<0.05)。腹腔镜组和开放手术组中位随访时间分别为22个月、20个月。腹腔镜组中位无病生存率(DFS)为34个月,开放手术组为29个月,无统计学差异(HR=0.641,P=0.255)。结论:腹腔镜下根治性子宫切除术治疗早期宫颈癌症的近期疗效较好。
Objective:To explore the short-term efficacy of laparoscopic radical hysterectomy for treating patients with early cervical cancer.Methods:This study included the patients with FIGO stage IA 1(lymphatic invasion),IA 2 and IB 1 cervical cancer who visited the hospital from September 2021 to December 2023.The patients were randomly divided into 60 patients with laparoscopic radical hysterectomy(LRH)in group A and 60 patients with open radical hysterectomy(ORH)in group B by a random number table.The short-term efficacy of the cervical cancer radical hysterectomy of the patients was compared between the two groups.Results:There were no significant differences in the operation time,the hospital stay,the incidence of bladder,ureter or intestinal injury,the number of lymph node dissection,the retention days of urinary catheter and drainage tube,the incidence of postoperative complications,the positive proportion of pelvic lavage fluid cytology and the positive proportion of vaginal margin pathology of the patients between the two groups(P>0.05).The vaginal stump closure time(9.7±0.3 min)of the patients in group A was significantly lower than that(13.5±0.4 min)of the patients in group B(P<0.05).The intraoperative blood loss(251.4±23.1 ml)of the patients in group A was significantly higher than that(296.7±26.6 ml)of the patients in group B(P<0.05).The proportion of the intraoperative blood transfusion of the patients in group A was significantly higher than that of the patients in group B(P<0.05).The median follow-up time of the patients in group A or in group B was 22 months or 20 months.The median disease-free survival(DFS)of the patients in group A or in group B was 34 months or 29 months,and which had statistically significant difference(HR=0.641,P=0.255).Conclusion:Laparoscopic radical hysterectomy for treating the patients with early cervical cancer has the better short-term efficacy.
作者
张利霞
南方
程佳
陈芳
ZHANG Lixia;NAN Fang;CHENGJia;CHEN Fang(Ezhou Central Hospital,Ezhou,Hubei Province,436000;Hubei Maternal and Child Health Care Hospital,Wuhan)
出处
《中国计划生育学杂志》
2025年第6期1280-1283,I0001,共5页
Chinese Journal of Family Planning
基金
湖北省卫生健康委2019年度第一批联合基金立项项目(WJ2019H190)。
关键词
宫颈癌
腹腔镜下子宫切除术
疗效
预后
Cervical cancer
Laparoscopic hysterectomy
Therapeutic effect
Prognosis
