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目的观察腹腔镜下宫颈癌根治术(LRH)与传统经腹宫颈癌根治术(ARH)治疗经新辅助动脉化疗(NAIC)后巨块型宫颈癌患者的临床评价指标,并探讨其可行性、安全性、近期疗效及临床应用价值。方法选取2012年1月-2016年6月在温州医科大学附属第五医院就诊的42例NAIC后巨块型宫颈癌患者为研究对象,根据手术方式分为LRH组18例,ARH组24例,比较两组患者的手术时间、手术出血量、清扫淋巴结数目、肛门排气时间、住院时间以及并发症(切口脂肪液化或感染、膀胱输尿管损伤、肠道损伤、尿潴留、深静脉血栓、淋巴囊肿、淋巴水肿、下肢疼痛或麻木等)的差异情况。结果两组手术时间、清扫淋巴结数目比较,差异无统计学意义(P>0.05);但LRH组手术出血量、肛门排气时间、住院时间明显少于ARH组(P<0.05)。LRH组切口脂肪液化或感染率、淋巴囊肿发生率低于ARH组(P<0.05);两组其他术后并发症发生率比较,差异无统计学意义(P>0.05)。结论 LRH组具有微创、手术出血少、术后恢复快、相关并发症少及住院时间短等明显优势,对NAIC后巨块型宫颈癌的手术近期疗效具有显著的优越性和重要的临床应用价值。
Objective To observe the clinical evaluation of patients with massive cervical cancer after laparoscopic radical hysterectomy (LRH) and traditional radical cystectomy (ARH) with neoadjuvant arterial chemotherapy (NAIC) and to investigate the feasibility, Safety, short-term efficacy and clinical value. Methods From January 2012 to June 2016, 42 NAIC patients with massive cervical cancer treated at the Fifth Affiliated Hospital of Wenzhou Medical College were enrolled. According to the surgical procedure, 18 cases were divided into LRH group, 24 ARH group, The operative time, operative bleeding volume, number of lymph nodes dissected, anal exhaust time, hospital stay and complications (incision fat liquefaction or infection, vesicoureteral injury, intestinal injury, urinary retention, deep venous thrombosis, lymphatic cyst , Lymphedema, lower extremity pain or numbness, etc.). Results There was no significant difference in operative time and number of lymph nodes between the two groups (P> 0.05). However, the amount of bleeding, time of discharge and hospital stay in LRH group were significantly less than those in ARH group (P <0.05). The rate of liquefaction or infection of fat in incision of LRH group was lower than that in ARH group (P <0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P> 0.05). Conclusions LRH group has the advantages of minimally invasive operation, less operation bleeding, quick recovery after operation, fewer complications and shorter hospital stay, which has significant advantages and short-term clinical application in the short-term curative effect of NAIC after massive cervical cancer value.