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为了探讨经腹筋膜外宫颈切除术的临床意义及价值,回顾分析因宫颈上皮内瘤变(CIN)Ⅲ和ⅠA1期宫颈鳞癌行经腹筋膜外宫颈切除术的32例患者的临床资料。结果显示,32例患者的平均手术时间80.0min(65～110min),平均出血量90.5mL(50～180mL),术后肠功能恢复时间28h(22～36h),住院时间7d(5～10d)。切除宫颈病理显示,切缘均未查见CIN及癌灶。术中膀胱损伤1例(3.1%),因出血结扎一侧子宫动脉1例(3.1%),术后宫颈残端粘连1例(3.1%)。患者均成功保留子宫体,随诊中未发现复发者。初步研究结果表明,经腹筋膜外宫颈切除术既可完整切除宫颈病变,又可保留子宫体,是已完成生育但要求保留子宫的年轻的CINⅢ和ⅠA1期宫颈癌的一种安全有效术式。
In order to investigate the clinical significance and value of transcervical hysterectomy, retrospective analysis of 32 patients with cervical intraepithelial neoplasia (CIN) Ⅲ and ⅠA1 cervical squamous cell carcinoma underwent transcervical hysterectomy were retrospectively analyzed. The mean operative time was 80.0min (65-110min), the mean amount of bleeding was 90.5mL (50-180mL), the recovery time of intestinal function was 28h (22-36h), the length of hospital stay was 7d (5-10d) . Cervical pathology showed no evidence of CIN and foci at the margin. One case (3.1%) had intraoperative bladder injury, one case (3.1%) had uterine artery hemorrhage and one case had cervical stump adhesion (3.1%). Patients were successfully preserved uterus, no recurrence found in the follow-up. Preliminary studies have shown that transcervical resection of the cervix can not only complete removal of cervical lesions, but also retain the uterus, is completed fertilization but asked to retain the uterus young CIN Ⅲ and Ⅰ A1 cervical cancer a safe and effective procedure.