改良腹式与全腹腔镜广泛宫颈切除术治疗早期宫颈癌的比较

发布时间：2018-06-21 01:39

本文选题：宫颈癌 + 保留生育功能　；参考：《实用妇产科杂志》2015年04期

【摘要】：目的:比较改良腹式广泛宫颈切除术(MART)与全腹腔镜广泛宫颈切除术(TLRT)在早期宫颈癌保留生育功能治疗中的技术异同性、临床治疗效果和妊娠结局。方法:收集2002年10月至2014年7月46例早期宫颈癌并接受MART或TLRT手术患者的临床资料和随访结果,并进行对比。结果:46例患者均完成预期手术,其中MART组27例,TLRT组19例。TLRT组术中出血量及住院时间明显少于MART组(P0.05),MART组在手术时间、切除宫旁组织长度、子宫动脉损伤率方面明显优于TLRT组(P0.05)。两组切除淋巴结数、腹腔引流量及膀胱功能障碍发生率等比较,差异无统计学意义(P0.05)。术后随访两组均无复发,MART组妊娠率(38.10%)与TLRT组(53.85%)比较,差异无统计学意义(P0.05)。结论:MART和TLRT两种手术方式均可有效治疗早期宫颈癌并实现患者保留生育功能的愿望。MART术式切除宫旁范围较TLRT相对较广,TLRT在减少术中出血及对盆腔脏器的干扰方面有其微创的优势。选择手术方式应个体化。
[Abstract]:Objective: to compare the technical differences, clinical effects and pregnancy outcomes between modified abdominal extensive cervical resection (MARTT) and total laparoscopic extensive cervical resection (TLRT) in the treatment of early cervical cancer with fertility retention. Methods: the clinical data and follow-up results of 46 patients with early cervical cancer underwent Mart or TLRT from October 2002 to July 2014 were collected and compared. Results the expected operation was performed in all 46 patients. The blood loss and hospital stay in the TLRT group (n = 27) were significantly lower than those in the Mart group (P 0.05), the length of paracentric tissue and the rate of uterine artery injury were significantly better than those in the TLRT group. There was no significant difference in the number of lymph nodes, abdominal drainage and bladder dysfunction between the two groups (P 0.05). There was no significant difference in pregnancy rate between the two groups (38.10%) and TLRT group (53.85%). Conclusion both of the two methods can be effective in the treatment of early cervical cancer and realize the wish of preserving fertility function of patients. The paracentric resection of TLRT is more extensive than that of TLRT. TLRT can reduce intraoperative bleeding and interfere with pelvic organs. Has its minimally invasive advantage. The choice of operation should be individualized.
【作者单位】：南方医科大学珠江医院;广州医学院第三附属医院;北京大学深圳医院;中山大学附属东华医院;
【基金】：广东省科学技术厅科技计划资助项目(编号:2005B36001017) 南方医科大学珠江医院人才引进基金
【分类号】：R737.33

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