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目的探讨年轻早期宫颈癌患者保留生殖功能的可行性及潜在风险。方法临床确诊为1期(1a-1b)的宫颈癌患者在全麻或双持硬膜外麻醉下施行手术,经腹膜外,分别清扫双侧髂总、髂外、髂内、闭孔、腹股沟深及腹股沟浅等各组淋巴结,并送冰冻病检。在阴道拉钩的帮助下,在穹隆顶处切开阴道粘膜,分离宫颈膀胱间隙、宫颈直肠间隙及两侧直肠侧窝;在近盆壁处钳夹、切断、缝扎双侧骶韧带;在宫颈内口水平切除宫颈,然后将阴道断端与子宫断端吻合。将宫颈组织送冰冻切片病检。结果9例患者中除1例在手术后13个月“阴道顶端”刮片发现癌细胞给予放疗外,其余8例患者已无癌生存1～3年。结论“早期宫颈癌经阴道宫颈根治性切除结合盆腔淋巴结清扫术”对年轻患者维持生殖生理功能具有重要意义,该技术的远期效果还有待观察和研究。
Objective To investigate the feasibility and potential risks of preserving reproductive function in young patients with early stage cervical cancer. Methods Patients with cervical cancer who were diagnosed as stage 1a-1b were operated under general anesthesia or double-support epidural anesthesia. The patients underwent extraperitoneal resection of bilateral common iliac, external iliac, internal iliac, obturator and groin Deep and groin shallow and other groups of lymph nodes, and send frozen disease examination. Vaginal retractor with the help of vaginal mucosa in the top of the dome incision, separation of cervical bladder space, cervical rectum space and bilateral rectal fossa; near the pelvic wall at the clamp, cut, suture bilateral sacral ligament; in the cervix The level of the cervix resection of the cervix, and then the ends of the vagina and the uterus stitched. Cervical tissue sent frozen section disease examination. Results Of the 9 patients, only 1 patient had radiotherapy after cancer was found at 13 months after operation. The other 8 patients had no cancer to survive for 1 to 3 years. Conclusion “Radical cervical excision combined with pelvic lymph node dissection in early cervical cancer” is of great significance for the maintenance of reproductive physiology in young patients. The long-term effect of this technique remains to be seen and studied.