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目的探讨腹腔镜广泛子宫切除(LRH)及盆腔淋巴清扫术治疗宫颈癌的近期疗效。方法比较LRH治疗43例宫颈癌患者(A组)和同期42例开腹手术患者(B组)手术时间、术中出血量、切除淋巴结数目、肛门排气时间、膀胱功能恢复时间和并发症发生情况等。结果 A组手术全部成功完成,无中转开腹。与B组比较,A组术中出血量少[(168.3±86.6)ml vs.(471.9±241.5)ml],术后发热时间短[(1.5±2.6)d vs.(5.3±4.6)d],术后肛门排气时间早[(20.4±3.8)h vs.(49.3±8.9)h](P<0.01或P<0.05)。A、B组切除淋巴结数目相仿[(18.3±8.8)枚vs.(17.3±6.8)枚](P>0.05)。A组术后膀胱功能恢复时间为(14.5±9.3)d,稍早于B组的(18.1±9.1)d(P>0.05)。A组术后补充放疗化疗者8例,B组9例。A、B组术后并发症发生率相仿(11.6%vs.14.3%)(P>0.05)。术后随访6-30个月,随访期间无复发。结论 LRH能达到宫颈癌常规开腹手术一样的切除效果,满足盆腔淋巴结清扫要求;且LRH手术创伤小、出血少、术后恢复快。
Objective To investigate the short-term effect of laparoscopic radical hysterectomy (LRH) and pelvic lymph node dissection in the treatment of cervical cancer. Methods The operative time, volume of intraoperative blood loss, the number of resected lymph nodes, the time of anal exhaust, the recovery time of bladder function and complication were compared among 43 patients with cervical cancer (group A) and 42 patients undergoing laparotomy (group B) Situation and so on. Results All the operations in group A were successfully completed and no laparotomy was performed. Compared with group B, group A had less blood loss (168.3 ± 86.6 ml vs. 471.9 ± 241.5 ml) and shorter postoperative fever (1.5 ± 2.6 d vs. 5.3 ± 4.6 d) , And the time of postoperative anal exhaust was as early as [(20.4 ± 3.8) h vs. (49.3 ± 8.9) h] (P <0.01 or P <0.05). The numbers of resected lymph nodes in groups A and B were similar [(18.3 ± 8.8) vs. (17.3 ± 6.8)] (P> 0.05). The recovery time of bladder function in group A was (14.5 ± 9.3) days, earlier than that in group B (18.1 ± 9.1 days) (P> 0.05). A group of postoperative radiotherapy and chemotherapy in 8 cases, B group 9 cases. The incidence of postoperative complications in groups A and B were similar (11.6% vs.14.3%) (P> 0.05). All the patients were followed up for 6-30 months without recurrence. Conclusions LRH can achieve the same resection effect as conventional laparotomy of cervical cancer and meet the requirements of pelvic lymph node dissection. LRH has less trauma, less bleeding and quick recovery after operation.