loading当代医学2019年10月第25卷第29期总第544期ContemporaryMedicine，Oct.2019，Vol.25No.29IssueNo.544
doi：10.3969/j.issn.1009-4393.2019.29.045
--论著--
腹腔镜治疗早期宫颈癌的临床分析
张萍，马新，高瑜，陈丽娟，黄海伟，赵芳
（张家港市第一人民医院妇科，江苏
摘要：目的
张家港215600）
选取2013年12月至2017年12月本院56例早
探讨腹腔镜根治性子宫切除术治疗早期宫颈癌的临床疗效与安全性。方法
期宫颈癌（ⅠA～ⅡB期）患者为研究对象，全部患者均以腹腔镜根治性子宫切除术进行治疗，术中广泛子宫切除，盆腔淋巴结清扫。观察患者基本手术指标，统计并发症及复发率，评价疗效与安全性。结果
56例患者均顺利完成手术，无中转开腹及死亡病例，术后病理示标本边缘无
残留病灶，手术切除彻底，成功率100.00%。手术时间（183.76±15.14）min，术中出血量（66.74±13.12）ml，术后通气时间（21.83±4.09）h，淋巴结切除数（26.42±3.74）个，术后住院时间（17.25±2.17）d。输尿管损伤3.57%，膀胱损伤3.57%，静脉损伤5.36%，闭孔神经损伤3.57%，经治疗及干预，无后遗症状。术后随访（17.25±6.3）个月，无肿瘤复发、穿刺点转移或宫颈癌相关死亡病例，复发率0.00%。结论性子宫切除术治疗早期宫颈癌效果确切、安全可行，值得临床推广使用。
关键词：早期宫颈癌；腹腔镜；根治性子宫切除术；疗效；安全性
腹腔镜根治
Clinicalanalysisoflaparoscopictreatmentforearly
cervicalcancer
ZhangPing,MaXin,GaoYu,ChenLijuan,HuangHaiwei,ZhaoFang
(DepartmentofGynaecology,theFirstPeople'sHospitalofZhangjiagangCity,Zhangjiagang,Jiangsu,215600,China)
Abstract:ObjectiveToevaluatetheefficacyandsafetyoflaparoscopicradicalhysterectomyforearlycervicalcancer.MethodsFromDecem-ber2013toDecember2017,56patientswithearlycervicalcancer(IA-IIB)inourhospitalwerestudied.Allpatientsweretreatedwithlaparoscopicradicalhysterectomywithextensivehysterectomyandpelviclymphnodedissection.Toevaluatetheefficacyandsafetyofthepatients,weobservedthebasicsurgicalindexes,thecomplicationsandtherecurrencerate.ResultsAllthe56patientshadsuccessfullycompletedtheoperation,andtherewerenocasesofconversiontolaparotomyordeath.Thepostoperativepathologyshowedthattherewerenoresiduallesionsinthemarginofthespec-imen,andtheoperationwasperformed.Inadditiontothorough,thesuccessratewas100.00%.Theoperativetimewas(183.76±15.14)min,thebloodlosswas(66.74±13.12)ml,theventilationtimewas(21.83±4.09)h,thenumberoflymphnodeswas(26.42±3.74)h,andthepostoperative
1877-1885.
[14]HoellS,SanderM,GoshegerG,etal.Theminimal
invasivedirectanteriorapproachincombinationwithlargeheadsintotalhiparthroplasty-isdis-locationstillamajorissue?Acasecontrolstudy[J].BMCMusculoskeletDisord,2014,15(1):80.
[15]TsukadaS,WakuiM.Lowerdislocationratefollowing
totalhiparthroplastyviadirectanteriorapproachthanviaposteriorapproach:five-year-averagefol-low-upresults[J].OpenOrthopJ,2015,9(1):157-162.[16]NamD,SculcoPK,AbdelMP,etal.Leg-lengthin-equalitiesfollowingTHAbasedonsurgicaltech-nique[J].Orthopedics,2013,36(4):E395-E400.[17]曾昭池,郭中凯,朱志勇,等.微创与常规全髋关节置换术的临
床疗效比较[J].中国矫形外科杂志,2013,21(12):1173-1176.
[18]倪喆,尚希福,吴科荣,等.直接前入路与后外侧入路全髋关节
置换术的近期临床效果对比[J].中华骨与关节外科杂志,
2018,11(7):518-521.
[19]JahngKH,BasMA,RodriguezJA,etal.Riskfactors
forwoundcomplicationsafterdirectanteriorap-proachhiparthroplasty[J].JArthroplasty,2016,31(11):2583-2587.
[20]ChenM,LuoZ,JiX,etal.Directanteriorapproach
fortotalhiparthroplastyinthelateraldecubitusposition:ourexperiencesandearlyresults[J].JArthroplasty,2017,32(1):131-138.
[21]王裕民,王敬博,李欣.微创前入路全髋关节置换治疗老年股
骨颈骨折[J].中国矫形外科杂志,2017,25(18):1694-1698.[22]HommaY,BabaT,SanoK,etal.Lateralfemoralcu-taneousnerveinjurywiththedirectanteriorap-proachfortotalhiparthroplasty[J].IntOrthop,2015,33(7):1-7.
[23]BartonC,KimPR.Complicationsofthedirectanteri-orapproachfortotalhiparthroplasty[J].OrthopClinNorth(Am),2009,40(3):371-375.
—112—