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目的:探讨改良的经阴道根治性子宫切除术治疗宫颈癌的临床疗效。方法:选择106例ⅠB～ⅡA期宫颈癌患者,随机分为研究组和对照组,两组均先接受腹腔镜下盆腔淋巴结切除术,其后研究组接受改良的经阴道根治性子宫切除术,对照组接受传统经阴道根治性子宫切除术。观察两组患者的手术时间、术中出血量、切除范围、手术并发症、肿瘤病理类型及泌尿系统的并发症。结果:所有患者均顺利完成手术。两组患者术中切除的阴道长度、骶韧带长度、主韧带长度以及盆腔淋巴结数目比较差异均无统计学意义(P均>0.05)。研究组的手术时间、分离输尿管时间、术后排气时间均短于对照组(P均<0.01),术中出血量亦少于对照组(P<0.01)。研究组无患者出现副损伤,而对照组发生膀胱损伤2例,输尿管损伤1例,均术中修补成功。研究患者术后膀胱功能障碍及尿路感染的发生率均明显低于对照组(P均<0.05)。结论:改良的经阴道根治性子宫切除术手术切除范围足够,手术时间短,术中出血量、副损伤、术后并发症均较传统术式明显减少,临床疗效确切,用于治疗宫颈癌是有效、可行的。
Objective: To investigate the clinical effect of modified radical vaginal hysterectomy in the treatment of cervical cancer. Methods: A total of 106 patients with stage ⅠB-ⅡA cervical cancer were selected and randomly divided into study group and control group. Both groups received laparoscopic pelvic lymphadenectomy. After that, the study group received modified radical vaginal hysterectomy, The control group received a conventional radical vaginal hysterectomy. The operation time, intraoperative blood loss, resection range, surgical complications, tumor pathological types and complications of the urinary system were observed in two groups. Results: All patients successfully completed the operation. There was no significant difference in vaginal length, length of sacral ligament, length of main ligament and number of pelvic lymph nodes between the two groups (all P> 0.05). The operation time, ureter time and postoperative exhaust time in the study group were shorter than those in the control group (all P <0.01). The bleeding volume in the study group was also less than that in the control group (P <0.01). No side injury occurred in the study group, while in the control group, 2 cases of bladder injury and 1 case of ureteral injury were repaired intraoperatively. The incidence of postoperative bladder dysfunction and urinary tract infection was significantly lower in the study patients than in the control group (all P <0.05). CONCLUSION: The modified radical vaginal hysterectomy has enough surgical resection scope, short operative time, intraoperative blood loss, side injury and postoperative complications compared with traditional surgical procedures. The clinical curative effect is exact and it is suitable for the treatment of cervical cancer Effective and feasible.