国际妇产科学杂志

国际妇产科学杂志 ›› 2014, Vol. 41 ›› Issue (5): 531-533.

• 论著 • 上一篇    下一篇

腹腔镜根治性宫颈切除术治疗早期宫颈癌的妊娠结局

朱定军，张蔚，吕琼莹，张娟，李菲，郑文静   

  1. 430060 武汉大学人民医院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-10-15 发布日期:2014-10-15
  • 通讯作者: 张蔚

Reproductive Outcomes after Laparoscopic Radical Trachelectomy for Early-stage Cervical Cancer

ZHU Ding-jun，ZHANG Wei，LYU Qiong-ying，ZHANG Juan，LI Fei，ZHENG Wen-jing   

  1. Renmin Hospital of Wuhan University，Wuhan 430060，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-10-15 Online:2014-10-15
  • Contact: ZHANG Wei

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摘要： 目的：评估早期年轻宫颈癌患者在腹腔镜下保留生育功能的根治性宫颈切除术（LRT）后的妊娠结局。方法：回顾性分析2006年4月—2013年12月武汉大学人民医院收治的早期宫颈癌患者行LRT的临床资料，妊娠结局的数据从患者的病历记录和电话回访中获得。结果：纳入22例成功行LRT的患者，中位年龄32岁（22～40岁），LRT后的平均随访时间是28个月（3～82个月）。手术后所有患者均恢复月经，其中20例月经规律（90.9%），2例月经不规律（9.1%）。5例患者出现宫颈管狭窄（22.7%），主要表现为月经规律但经量减少，出现痛经。些患者采取了宫颈管扩张术。12例患者在术后试图妊娠，其中7例妊娠了11次（其中3次流产，6次早产和2次足月产）。12例患者中的7例生产了6例健康婴儿。LRT术后的妊娠率是58.3%（7/12）。自然流产率和活产率分别是27.3%（3/11）和72.7%（8/11），早产率是54.5%（6/11）。结论：LRT术后患者的妊娠率和活产率是很有前途的；然而其早产率也明显增高；宫颈狭窄发生比例较低。

关键词: 宫颈肿瘤, 腹腔镜, 子宫颈, 子宫切除术, 妊娠结局

Abstract: Objective： The objective of this study was to estimate the reproductive outcome of young women with early-stage cervical cancer who underwent fertility-sparing laparoscopic radical trachelectomy（LRT）. Methods：We performed a retrospective review of the medical records of patients with early-stage cervical cancer who underwent LRT from April 2006 to December 2013. Clinicopathological data were obtained from patient medical records，and reproductive outcome data were obtained from patient medical records and telephone interviews. Results：Twenty-two patients who underwent successful LRT were included in this study. The median age of patients was 32 years （range，22 to 40 years），and the median follow-up time after LRT was 28 months （range，3 to 82 months）. Menstruation resumed in all patients after LRT，with twenty patients（90.9%） and two patients （9.1%） reporting regular and irregular menstruation，respectively. Five patients（22.7%） presented with cervical stenosis，which was manifested by regular but decreased menstrual flow and newly-developed dysmenorrhea. These patients underwent cervical cannulation and dilatation. Eleven pregnancies（including 3 missed abortions，6 preterm births and 2 full-term births） occurred in 7 patients after LRT. Seven out of 12 patients gave birth to 6 healthy babies. The pregnancy rate after LRT was 58.3%（7/12）. The spontaneous abortion rate and live birth rate were 27.3%（3/11） and 72.7%（8/11），respectively. The preterm birth rate was 54.5%（6/11）. Conclusions：Pregnancy and live birth rates after LRT were promising; however，the preterm birth rate was relatively high. Cervical stenosis also occurred in a small percentage of patients.

Key words: Uterine cervical neoplasms, Laparoscopes, Cervix uteri, Hysterectomy, Pregnancy outcome