CAJ | 학술논문

目的：探讨保留输尿管系膜的腹腔镜广泛子宫切除术治疗ⅠB1～ⅡA期宫颈癌的可行性，并评价其安全性和疗效。方法选取2012年1月至2014年11月在我院接受保留输尿管系膜的腹腔镜广泛子宫切除术的24例ⅠB1～ⅡA期宫颈癌患者作为研究组，以2009年1月至2011年12月接受腹腔镜保留神经广泛子宫切除术（L N RS H ）的24例患者作为对照组。比较两组手术的各项相关指标及术后膀胱、直肠功能的恢复情况。结果研究组平均手术时间较对照组明显缩短（P＜0．05），两组术中出血量、平均住院时间、术后第8天膀胱功能恢复例数、膀胱功能恢复时间、肛门排气及排便时间比较，差异无统计学意义（ P＞0．05）。两组患者随访6～24个月，无阴道残端及腹壁穿刺口复发病例。结论保留输尿管系膜的腹腔镜广泛子宫切除术在技术上是安全、可行的，与LNSRH手术效果相当，且简化了手术步骤，更有利于患者术后膀胱、直肠功能的恢复。
목적：탐토보류수뇨관계막적복강경엄범자궁절제술치료ⅠB1～ⅡA기궁경암적가행성，병평개기안전성화료효。방법선취2012년1월지2014년11월재아원접수보류수뇨관계막적복강경엄범자궁절제술적24례ⅠB1～ⅡA기궁경암환자작위연구조，이2009년1월지2011년12월접수복강경보류신경엄범자궁절제술（L N RS H ）적24례환자작위대조조。비교량조수술적각항상관지표급술후방광、직장공능적회복정황。결과연구조평균수술시간교대조조명현축단（P＜0．05），량조술중출혈량、평균주원시간、술후제8천방광공능회복례수、방광공능회복시간、항문배기급배편시간비교，차이무통계학의의（ P＞0．05）。량조환자수방6～24개월，무음도잔단급복벽천자구복발병례。결론보류수뇨관계막적복강경엄범자궁절제술재기술상시안전、가행적，여LNSRH수술효과상당，차간화료수술보취，경유리우환자술후방광、직장공능적회복。
Objective To study the feasibility of ureteral fascia preserved laparoscopic radical hysterectomy for treatment of ⅠB1‐ⅡA cervical carcinoma and to evaluate its safety and efficacy . Methods Choosing 24 cases of ⅠB1‐Ⅱ A cervical cancer patients w ho received ureteral fascia pre‐served laparoscopic radical hysterectomy in the obstetrics of Anyang Chinese Medicine Hospital from January 2012 to November 2014 as the study group .Choosing 24 patients who received routine lapa‐roscopic radical hysterectomy as the control group .We compared the related factors in operation , postoperative functional recovery of bladder and gastrointestinal tract between the two groups . Re‐sults The operation time of the study group was significantly less than that of the control group (P<0 .05) .But the blood loss ,the average hospital time ,the average time of the recovery time of bladder and gastrointestinal tract and the number of recovery cases at the 8th day post operation were not statistically significant different between the two groups (P>0 .05) .All cases were followed up from 6 to 24 months ,and no recurrence at the abdominal puncture site or the vaginal stump was found . Conclusions The ureteral fascia preserved laparoscopic radical hysterectomy is safe ,simple and effective .And it is beneficial to postoperative function recovery of bladder and gastrointestinal tract after operation .