CAJ | 학술논문

目的：探讨腹腔镜下宫颈癌根治术（laparoscopic radical hysterectomy，LRH）加盆腔淋巴结清扫术治疗宫颈癌的可行性、安全性及临床推广价值．方法收集2009年6月至2013年6月昆明医科大学第三附属医院妇瘤科收治的80例LRH组患者的临床资料，分析LRH在昆明医科大学第三附属医院妇瘤科的开展情况及其学习曲线．选取40例于2012年6月至2013年6月期间行传统经腹宫颈癌根治术（abdominal radical hysterectomy， ARH）加盆腔淋巴结清扫术的患者作为对照组，并在同时期2组间进行相关指标对比分析．结果按LRH开展时期先后以40例为界限分为A、B 2组，与A组相比，B组手术时间缩短约26.9%，术中出血量减少约37.3%，淋巴结清除量增加约37.2%，术中并发症降低约7.5%，住院时间平均减少约2.2 d，住院总费用有所减少但无显著性差异（＞0.05）．LRH的学习曲线约40例左右．2012年6月至2013年6月同时期LRH组患者在多项指标上均优于ARH组．术后随访2～48个月，ARH组1例复发，LRH组未见复发病例．结论 LRH在昆明医科大学第三附属医开展情况良好且安全可行，并以其手术创伤小、患者痛苦少、术后恢复快、手术瘢痕小、符合美学要求等优点，具有广阔的临床应用前景并值得向临床推广普及．
목적：탐토복강경하궁경암근치술（laparoscopic radical hysterectomy，LRH）가분강림파결청소술치료궁경암적가행성、안전성급림상추엄개치．방법수집2009년6월지2013년6월곤명의과대학제삼부속의원부류과수치적80례LRH조환자적림상자료，분석LRH재곤명의과대학제삼부속의원부류과적개전정황급기학습곡선．선취40례우2012년6월지2013년6월기간행전통경복궁경암근치술（abdominal radical hysterectomy， ARH）가분강림파결청소술적환자작위대조조，병재동시기2조간진행상관지표대비분석．결과안LRH개전시기선후이40례위계한분위A、B 2조，여A조상비，B조수술시간축단약26.9%，술중출혈량감소약37.3%，림파결청제량증가약37.2%，술중병발증강저약7.5%，주원시간평균감소약2.2 d，주원총비용유소감소단무현저성차이（＞0.05）．LRH적학습곡선약40례좌우．2012년6월지2013년6월동시기LRH조환자재다항지표상균우우ARH조．술후수방2～48개월，ARH조1례복발，LRH조미견복발병례．결론 LRH재곤명의과대학제삼부속의개전정황량호차안전가행，병이기수술창상소、환자통고소、술후회복쾌、수술반흔소、부합미학요구등우점，구유엄활적림상응용전경병치득향림상추엄보급．
Objective To study the feasibility, safety and clinical application value of LRH, comparing with abdominal radical hysterectomy (ARH) . Methods A total of 80 patients' clinical data were collected to analyze the development of LRH in Yunnan Tumor Hospital while compared with another 40 patients between June 2012 to June 2013 of ARH for some associative indexes. Results The patients were divided into group A and B equally.Compared with Grope A, the time of operation decreased 26.9%, 37.2% has been augment for lymph gland sweeping, the amount of bleeding and intraoperative complication reduced 37.3% and 7.5% in Grope D, respectively, with distinctive difference ( >0.05) .Hospitalization expenses had a small degree reduced but no distinctive difference.The learning curve of LRH was 40 approximately.Comparison between LRH and ARH in the same period showed that LRH was more splendid than ARH in several index.1 case relapsed in 2-48 months follow-up in ARH while no relapse in the other group. Conclusion LRH is safe and feasible and has good prospects in clinical application and deserves clinical generalization because of its advantages such as less trauma,less pains, quick recovery,less scars and aesthetical appearance.