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目的分析子宫颈癌根治术后并发症及其相关因素,探讨其防治措施。方法1995年1月至2003年12月间,施行子宫颈癌根治术219例。其中ⅠA期26例(ⅠA1期17例,ⅠA2期9例),ⅠB期142例(ⅠB1期78例,ⅠB2期64例),ⅡA期40例,ⅡB期3例,另外8例为外院治疗后无法分期。采用子宫颈癌根治术204例,改良子宫颈癌根治术15例。结果发生手术并发症49例,发生率为22.4%。手术并发症主要为尿潴留、淋巴囊肿、腹部伤口感染,其发生率分别为10.0%、7.8%和6.8%。子宫颈癌根治术并发症发生率高于改良子宫颈癌根治术。术前外院介入化疗、根治性放疗和既往有腹部手术史者的手术并发症发生率为分别为50.0%(2/4)、100%(1/1)和25.0%(13/52),差异无统计学意义。87例术前辅助放疗的手术并发症发生率(25.3%)高于未辅助放疗者(19.4%),但差异无统计学意义(P=0.239)。结论子宫颈癌根治术后并发症与术式有关,术前辅助腔内后装放疗不增加并发症,适当缩小手术范围可减少手术并发症。
Objective To analyze the complications and related factors after radical operation of cervical cancer and to explore its prevention and treatment. Methods Between January 1995 and December 2003, 219 cases of cervical cancer radical mastectomy were performed. Among them, 26 cases were stage IA, 17 cases were stage IA, 9 cases were stage IA, 142 cases were stage IB, 78 cases were stage IB, 64 cases were stage IB, 40 cases were stage IIA, 3 cases were stage IIB, Can not be staged. 204 cases were treated with radical mastectomy of cervical cancer and 15 cases were treated with radical mastectomy of cervical cancer. Results 49 cases of surgical complications occurred, the incidence was 22.4%. Complications of surgery mainly urinary retention, lymphatic cyst, abdominal wound infection, the incidence rates were 10.0%, 7.8% and 6.8%. Cervical cancer radical complication rate is higher than radical cervical cancer radical operation. The incidences of preoperative and postoperative external interventional chemotherapy, radical radiotherapy and history of previous abdominal surgery were 50.0% (2/4), 100% (1/1) and 25.0% (13/52), respectively No statistical significance. The incidence of operative complications in preoperative adjuvant radiotherapy was higher in 87 (25.3%) than in non-adjuvant radiotherapy (19.4%), but the difference was not statistically significant (P = 0.239). Conclusions The complications after radical operation of cervical cancer are related to the operative procedure. Preoperative adjuvant intracavitary postoperative radiotherapy does not increase the complication. Appropriately narrowing the operative range can reduce the surgical complications.