CAJ | 학술논문

目的：探讨腹腔镜下广泛子宫切除术联合盆腔淋巴结切除术治疗早期宫颈癌的近期临床效果。方法：选择2007年07月～2012年6月的113例I a2～II a期的子宫颈癌患者，腹腔镜下施行广泛性子宫切除联合盆腔淋巴结切除，术前影像学或术中见淋巴结肿大者行腹主动脉淋巴结切除。并对其临床资料及随访情况进行回顾性分析。结果：除1例中转开腹外其余112例（99．2％）均在腹腔镜下完成。手术时间175～246分钟，平均215分钟，术中出血量50～510ml，平均165 ml。切除盆腔淋巴结l7～37枚，平均21枚；术后肠道功能恢复时间24～50小时，平均32小时；术后留置尿管时间14～60天，平均16．5天。术中并发症2例（1．8％）：髂血管损伤1例，输尿管损伤1例。术后近期并发症8例（7．1％），分别盆腔感染2例，膀胱阴道瘘1例，输尿管阴道瘘1例，淋巴囊肿4例。术后远期并发症：膀胱功能障碍7例（6．2％）。结论：腹腔镜下广泛子宫切除联合盆腔淋巴结切除术治疗早期宫颈癌近期效果肯定、安全可行。
목적：탐토복강경하엄범자궁절제술연합분강림파결절제술치료조기궁경암적근기림상효과。방법：선택2007년07월～2012년6월적113례I a2～II a기적자궁경암환자，복강경하시행엄범성자궁절제연합분강림파결절제，술전영상학혹술중견림파결종대자행복주동맥림파결절제。병대기림상자료급수방정황진행회고성분석。결과：제1례중전개복외기여112례（99．2％）균재복강경하완성。수술시간175～246분종，평균215분종，술중출혈량50～510ml，평균165 ml。절제분강림파결l7～37매，평균21매；술후장도공능회복시간24～50소시，평균32소시；술후류치뇨관시간14～60천，평균16．5천。술중병발증2례（1．8％）：가혈관손상1례，수뇨관손상1례。술후근기병발증8례（7．1％），분별분강감염2례，방광음도루1례，수뇨관음도루1례，림파낭종4례。술후원기병발증：방광공능장애7례（6．2％）。결론：복강경하엄범자궁절제연합분강림파결절제술치료조기궁경암근기효과긍정、안전가행。
Objective:To discuss the near future clinical effect of laparoscopic radical hysterectomy and pelvic lymphadenectomy in treatment of early cervical cancer .Methods:To select 113 cases of stage Ia2-IIa period in patients with cervical carcinoma between july 2007-june 2012 , radical hysterectomy and pelvic lymphadenectomy with laparoscopy during endotracheal intubation under general anes -thesia,and retrospectively analyzed of the clinical information and follow -up data.Results:Except one cases were converted to laparotomy and the other 112 cases were performed by laparoscopy .Operation time for 175~246seconds,an average of 215 seconds;intraoperative blood loss for 50-510ml,an average of 165ml;resection of pelvic lymph nodes for 17-37,an average of 21;postoperative intestinal func-tion recovery time is 24-50 hours,an average of 32 hours;postoperative indwelling catheter time of 14-60 days, an average of 16.5 days.Have 2 cases of postoperative complications:1 cases of iliac-vessel injury ,1 cases of ureteral injury .Have 8 cases of near postoper-ative complications ,include:2 cases of pelvic infection ,2 cases of vesicovaginal fistula ,4 cases of lymphatic cyst .Late postoperative com-plications:7 cases of bladder dysfunction .Conclusion:The near future clinical effect of Laparoscopic radical hysterectomy and pelvic lymphadenectomy in the treatment of early cervical cancer should be safe and feasible .