阴式子宫颈广泛性切除术治疗早期子宫颈癌的临床疗效及对生育结局的影响

doi:10.3760/cma.j.issn.1673-422X.2016.06.006

摘要/Abstract

摘要： 目的探讨阴式子宫颈广泛性切除术（VRT）治疗早期子宫颈癌的临床疗效及对生育结局的影响。方法回顾性分析并随访2005年6月至2014年5月于我院行宫颈广泛性切除术治疗的60例早期子宫颈癌年轻患者。根据手术方式分为两组：VRT组32例，腹式子宫颈广泛性切除术(ART)组28例，对两组患者的临床疗效及生育结局进行比较分析。结果 VRT组患者术中出血量明显少于ART组［(278.00±97.00)ml∶(496.00±135.00)ml，t=7.247，P<0.05］，阴道切除长度及宫旁组织切除宽度均明显短于ART组［(2.58±0.33)cm∶(3.01±0.19)cm，t=6.277，P＜0.05；(2.34±0.31)cm∶(2.88±0.25)cm，t=7.357，P＜0.05］。随访期间，VRT组患者复发率明显低于ART组（3.1%∶25.0%，χ2=6.18，P＜0.05）。早期宫颈癌患者的复发与年龄（χ2=21.33，P＜0.05）、肿瘤直径（χ2=21.43，P＜0.05）、病理类型（χ2=40.69，P＜0.05）及手术类型（χ2=6.18，P＜0.05）有关。VRT组患者妊娠率及分娩率均明显高于ART组（37.5%∶25.0%，χ2=15.33，P＜0.05；28.1%∶17.9%，χ2=10.32，P＜0.05）。结论 VRT治疗早期子宫颈癌安全可行，可减少手术损伤，降低复发率，并能有效保留早期子宫颈癌患者的生育功能，值得临床推广应用。

关键词: 宫颈肿瘤, 生育力, 子宫颈广泛性切除术

Abstract: Objective To explore clinical effect and effect on fertility outcomes of vaginal radical trachelectomy (VRT) in young patients with early stage of cervical cancer. MethodsSixty cases of young patients with early stage of cervical cancer treated with radical trachelectomy in our hospital between June 2005 and May 2014 were retrospectively analyzed and conducted followup visits. The patients were divided into two groups based on different operation methods: VRT group (n=32) and abdominal radical trachelectomy (ART) group (n=28). The clinical effects and fertility outcomes of the two groups were compared. ResultsThe blood loss of VRT group was significantly lesser than that of ART group ［(278.00±97.00)ml vs. (496.00±135.00)ml, t=7.247, P<0.05］. The length of vaginal hysterectomy and the width of parametrial resection of VRT group were significantly shorter than those of ART group ［(2.58±0.33)cm vs. (3.01±0.19)cm, t=6.277, P＜0.05; (2.34±0.31)cm vs. (2.88±0.25)cm, t=7.357, P＜0.05］. During the followup visits, the recurrence rate of VRT group was significantly lower than that of ART group (3.1% vs. 25.0%, χ2=6.18, P＜0.05). The recurrence of early cervical cancer was related to age (χ2=21.33, P＜0.05), diameter of tumor (χ2=21.43, P＜0.05), pathology (χ2=40.69, P＜0.05) and operation methods (χ2=6.18, P＜0.05). The pregnancy rate and fertility rate of VRT group were significantly higher than those of ART group (37.5% vs. 25.0%, χ2=15.33, P＜0.05; 28.1% vs. 17.9%, χ2=10.32, P＜0.05). Conclusion VRT for young patients with early cervical cancer is safe and feasible. It′s worthy of clinical promotion because it can reduce operation damage and recurrence rate, and can efficiently preserve the fertility of patients.

Key words: Uterine cervical neoplasms, Fertility, Radical trachelectomy

王德山. 阴式子宫颈广泛性切除术治疗早期子宫颈癌的临床疗效及对生育结局的影响[J]. 国际肿瘤学杂志, 2016, 43(6): 424-427.

Wang Deshan. Clinical effect and influence on fertility outcomes of vaginal radical trachelectomy in young patients with early stage of cervical cancer[J]. Journal of International Oncology, 2016, 43(6): 424-427.

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