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目的研究接受腹腔镜下广泛性子宫切除术的宫颈癌患者,术前宫颈锥切术对随后的腹腔镜下广泛性子宫切除术的影响。方法对大连市妇产医院及营口市妇产医院2005年4月~2011年8月接受腹腔镜下广泛性子宫切及盆腔淋巴结切除的宫颈癌患者的医学病历进行回顾性分析。根据宫颈锥切腹腔镜下广泛性子宫切除及盆腔淋巴结切除的间隔将病人分为3组:组1:间隔期<6周(17例);组2:间隔期>6周(38例);对照组为组3:术前未行宫颈锥切的宫颈癌患者(40例)。结果 3组患者的一般资料(年龄、产次、体重指数)差异无统计学意义;平均手术时间、失血量、中转开腹率有显著差异,组1高于组2和组3,组2和组3差异无统计学意义(P<0.05)。结论宫颈锥切术后行腹腔镜下广泛性子宫切除及盆腔淋巴结清扫是可行的,仔细地分离膀胱、输尿管与子宫间隙有利于减少术后并发症,合适的宫颈锥切腹腔镜下广泛性子宫切除术的间隔为>6周。
Objective To investigate the effect of preoperative cervical conization on the subsequent laparoscopic radical hysterectomy in patients undergoing laparoscopic radical hysterectomy. Methods The medical records of cervical cancer patients undergoing laparoscopic radical hysterectomy and pelvic lymph node dissection in Dalian Maternity Hospital and Yingkou Maternity Hospital from April 2005 to August 2011 were analyzed retrospectively. Patients were divided into 3 groups according to the laparoscopic radical hysterectomy and pelvic lymphadenectomy interval: Group 1: Interval period <6 weeks (17 cases); Group 2: Interval period> 6 weeks (38 cases); The control group was Group 3: cervical cancer without conization before surgery (40 cases). Results There was no significant difference in the general data (age, parity, body mass index) between the three groups. The mean operative time, blood loss and the rate of laparotomy were significantly different in group 3, group 2 and group 3 Group 3 had no significant difference (P <0.05). Conclusions Laparoscopic radical hysterectomy and pelvic lymphadenectomy are feasible after conization of the cervix. Careful separation of the bladder, ureter and uterine space is helpful to reduce the postoperative complications. The appropriate uterine cervix conization laparoscopic wide uterus The resection interval was> 6 weeks.