癌症进展
癌癥進展
암증진전
ONCOLOGY PROGRESS
2015年
3期
342-345
,共4页
梅耀玲%陈君茂%胡珊姗%程欣
梅耀玲%陳君茂%鬍珊姍%程訢
매요령%진군무%호산산%정흔
阴式广泛性宫颈切除术%生育%妊娠%复发%宫颈癌
陰式廣汎性宮頸切除術%生育%妊娠%複髮%宮頸癌
음식엄범성궁경절제술%생육%임신%복발%궁경암
VRT%fertility%pregnancy%recurrence%cervical cancer
目的：探讨阴式广泛性宫颈切除术（vaginal radical trachelectomy，VRT）对宫颈癌患者复发和生育的影响。方法回顾性分析208例早期宫颈癌患者资料，有195例患者成功接受VRT手术，且均保留了生育功能；记录195例患者的手术指标、复发情况和生育情况，并进行随访。结果手术平均时间为（179.56±37.17） min，术中出血量为（325.79±127.54）ml，术中切除淋巴结的数目为（24.47±9.83）枚，切除宫颈的长度为（2.63±0.68）cm；出现术中并发症者有4例，出现术后并发症者8例；术后总复发率为12.31%（24/195），复发部位以宫旁最多见（66.67%，16/24）；171例鳞癌患者中共有12例（7.02%）复发，16例腺癌患者和8例腺鳞癌患者中共有12例（50.00%）复发，复发率的差异具有统计学意义（P＜0.05）；肿瘤＞2 cm的32例患者中有13例（40.63%）复发，肿瘤≤2 cm的163例患者中有11例（6.75%）复发，差异具有统计学意义（P＜0.05）；141例患者具有妊娠的意愿，其中有55例生育，生育率为39.01%；肿瘤直径≤2 cm的患者与＞2cm的患者之间的生育率差异无统计学意义（P＞0.05）。结论 VRT在保留患者的生育功能方面是比较成熟的，肿瘤直径大于2 cm是患者术后复发的危险因素。
目的：探討陰式廣汎性宮頸切除術（vaginal radical trachelectomy，VRT）對宮頸癌患者複髮和生育的影響。方法迴顧性分析208例早期宮頸癌患者資料，有195例患者成功接受VRT手術，且均保留瞭生育功能；記錄195例患者的手術指標、複髮情況和生育情況，併進行隨訪。結果手術平均時間為（179.56±37.17） min，術中齣血量為（325.79±127.54）ml，術中切除淋巴結的數目為（24.47±9.83）枚，切除宮頸的長度為（2.63±0.68）cm；齣現術中併髮癥者有4例，齣現術後併髮癥者8例；術後總複髮率為12.31%（24/195），複髮部位以宮徬最多見（66.67%，16/24）；171例鱗癌患者中共有12例（7.02%）複髮，16例腺癌患者和8例腺鱗癌患者中共有12例（50.00%）複髮，複髮率的差異具有統計學意義（P＜0.05）；腫瘤＞2 cm的32例患者中有13例（40.63%）複髮，腫瘤≤2 cm的163例患者中有11例（6.75%）複髮，差異具有統計學意義（P＜0.05）；141例患者具有妊娠的意願，其中有55例生育，生育率為39.01%；腫瘤直徑≤2 cm的患者與＞2cm的患者之間的生育率差異無統計學意義（P＞0.05）。結論 VRT在保留患者的生育功能方麵是比較成熟的，腫瘤直徑大于2 cm是患者術後複髮的危險因素。
목적：탐토음식엄범성궁경절제술（vaginal radical trachelectomy，VRT）대궁경암환자복발화생육적영향。방법회고성분석208례조기궁경암환자자료，유195례환자성공접수VRT수술，차균보류료생육공능；기록195례환자적수술지표、복발정황화생육정황，병진행수방。결과수술평균시간위（179.56±37.17） min，술중출혈량위（325.79±127.54）ml，술중절제림파결적수목위（24.47±9.83）매，절제궁경적장도위（2.63±0.68）cm；출현술중병발증자유4례，출현술후병발증자8례；술후총복발솔위12.31%（24/195），복발부위이궁방최다견（66.67%，16/24）；171례린암환자중공유12례（7.02%）복발，16례선암환자화8례선린암환자중공유12례（50.00%）복발，복발솔적차이구유통계학의의（P＜0.05）；종류＞2 cm적32례환자중유13례（40.63%）복발，종류≤2 cm적163례환자중유11례（6.75%）복발，차이구유통계학의의（P＜0.05）；141례환자구유임신적의원，기중유55례생육，생육솔위39.01%；종류직경≤2 cm적환자여＞2cm적환자지간적생육솔차이무통계학의의（P＞0.05）。결론 VRT재보류환자적생육공능방면시비교성숙적，종류직경대우2 cm시환자술후복발적위험인소。
Objective To investigate the recurrence rate and fertility outcomes of cervical cancer patients treated with vaginal radical trachelectomy (VRT). Method A retrospective analysis was conducted in 208 cases with early stage cervical cancer, in which 195 cases had successful VRT with fertility preserved, and were followed up and their surgery parameters, recurrence and fertility outcomes were documented. Result The average operative time was (179.56 ± 37.17) min, the bleeding volume was (325.79 ± 127.54) ml, number of resected lymph nodes was (24.47 ± 9.83), length of resected uterine cervix was (2.63 ± 0.68) cm; intra-operative complications occurred in 4 cases, while 8 cases had postoperative complications; the total recurrence rate was 12.31% (24/195), the site with the highest re-currence was parametrium (66.67%, 16/24); Twelve (7.02%,) cases in 171 squamous patients experienced recurrence, and there were 12 (50.0%, 12/24) relapsed cases in 16 adenocarcinoma and 8 adenosquamous carcinoma patients, and the difference of recurrence rate regarding tumor type was statistically significant (P < 0.05). Thirteen patients in 32 cases with tumor size >2 cm had recurrence (40.63%), of the 163 cases of patients with tumor ≤2 cm, there were 11 recurrence cases (6.75%), which was significantly less (P < 0.05); Of the 141 patients who had intention of pregnan-cy, 55 (39.01%) became pregnant; No statistically significant difference was observed between patients with tumor >2 cm and ≤2 cm (P > 0.05). Conclusion VRT is a mature surgical modality in respect of preserving fertility of pa-tients, and tumor diameter greater than 2 cm is a risk factor of postoperative recurrence in patients with cervical can-cer.
