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目的探讨腹腔镜阴式广泛性子宫颈切除术(LVRT)治疗早期宫颈癌的临床效果、手术指征和高危患者的处理原则。方法回顾性分析2003年12月至2005年11月2年间,16例早期宫颈癌患者进行LVRT的临床资料。结果16例患者平均年龄为29岁(26~34岁),11例未生育,4例已有子女,但所有患者均要求保留生育功能。国际妇产科联盟(FIGO)分期为2例Ⅰa2期,13例Ⅰb1期和1例Ⅰb2期;15例鳞癌,1例腺鳞癌。手术的平均时间3·20h,平均出血量320ml。16例患者中无泌尿道、肠道损伤和术中大出血等严重并发症发生。平均随诊时间13个月,1例复发,复发率为6%。无患者在治疗后的随诊期内妊娠。结论对早期宫颈癌患者施行以LVRT为主的保留生育功能的治疗是可行的。
Objective To investigate the clinical effects, surgical indications and treatment principles of patients with early cervical cancer undergoing laparoscopic vaginal extensive cervical resection (LVRT). Methods The clinical data of 16 patients with early cervical cancer who underwent LVRT from December 2003 to November 2005 were analyzed retrospectively. Results The average age of 16 patients was 29 years old (26 to 34 years old). Eleven children did not have children and 4 children had children. However, all patients were required to retain fertility. The International Union of Gynecology and Obstetrics (FIGO) stage was 2 cases of stage Ⅰ a2, 13 cases of stage Ⅰ 1b and 1 stage Ⅰ b2; 15 cases of squamous cell carcinoma, 1 case of adenosquamous carcinoma. The average time of surgery 3 · 20h, the average amount of bleeding 320ml. 16 patients without urinary tract, intestinal injury and intraoperative bleeding and other serious complications. The average follow-up time of 13 months, 1 case of recurrence, the recurrence rate was 6%. None of the patients were pregnant during the follow-up period after treatment. Conclusions The treatment of early cervical cancer with LVRT-based fertility preservation is feasible.