国际妇产科学杂志

国际妇产科学杂志 ›› 2013, Vol. 40 ›› Issue (4): 321-323.

• 论著 • 上一篇    下一篇

腹腔镜下广泛子宫颈切除术治疗早期子宫颈鳞状细胞癌的初步研究

鲁 琦, 张云鹤, 王淑珍, 郭淑丽, 刘崇东, 张震宇   

  1. 100020 北京，首都医科大学附属北京朝阳医院妇产科（鲁 琦，王淑珍，郭淑丽，刘崇东，张震宇）；中国航天科工集团七三一医院妇产科（张云鹤）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2013-08-15 发布日期:2013-08-15
  • 通讯作者: 刘崇东

Total Laparoscopic Radical Trachelectomy in the Treatment of Early Squamous Cell Cervical Cancer：a Pilot Study

LU Qi，ZHANG Yun-he， WANG Shu-zhen， GUO Shu-li， LIU Chong-dong， ZHANG Zhen-yu   

  1. Department of Obstetrics and Gynecology， Chao-yang Hospital， Capital Medical University， Beijing 100020， China（LU Qi， WANG Shu-zhen， GUO Shu-li， LIU Chong-dong， ZHANG Zhen-yu）； Department of Obstetrics and Gynecology， 731 Hospital，China Aerospace Science and Industry Corporation ，Beijing 100074，China（ZHANG Yun-he）
  • Received:1900-01-01 Revised:1900-01-01 Published:2013-08-15 Online:2013-08-15
  • Contact: LIU Chong-dong

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摘要： 目的：探讨完全腹腔镜下广泛宫颈切除术治疗早期宫颈鳞癌的远期肿瘤结局及妊娠结局。方法：以2005年1月—2009年12月于首都医科大学附属北京朝阳医院妇产科经完全性腹腔镜下广泛宫颈切除术治疗的12例早期宫颈鳞癌患者为研究对象，收集临床资料及随访结果，对数据进行分析。结果：12例患者平均年龄27（22~34）岁。国际妇产科联盟（FIGO）分期为IA2期7例，IB1期5例。12例患者的组织学类型均为鳞癌。平均手术时间233（200～320）min，平均出血量153（50～200 ）mL。12例均为接受完全腹腔镜下宫颈广泛切除术的患者，在58个月的中位随访时间中，均无肿瘤复发。4例患者术后长期避孕，4例患者自然妊娠，2例在妊娠早期自然流产，1例于妊娠29周时因胎膜早破行剖宫产，1例于妊娠37周时行剖宫产终止妊娠。结论：完全腹腔镜下广泛宫颈切除术治疗早期宫颈鳞癌是安全可行的，但仍需大样本的前瞻性研究对妊娠结局进行评估。

关键词: 宫颈肿瘤, 肿瘤, 鳞状细胞, 生育力, 腹腔镜, 子宫切除术

Abstract: Objective： To evaluate the surgical，oncologic，and obstetrical outcomes of total laparoscopic radical trachelectomy（TLRT） in patients with early-stage cervical cancer who want to preserve their fertility. Methods： Twenty-five patients with early-stage cervical cancer were treated by TLRT from January 2005 to December 2009. Data regarding operational time，blood loss， intraoperative-and post-operative complications， recurrence， and subsequent pregnancies were recorded. Results：The median age of the patients was 27 years（range， 22-34 years）. The median surgical time was 233 min（range， 200-320 min）. The median blood loss was 153 mL（range， 50-200 mL）， and the median length of hospitalization was 3.3 days （range， 2-4 days）. No intra-operative complications occurred；three patients had post-operative complications. The median follow-up time was 58 months（range， 36-82 months）， and no recurrences were observed. Eight patients attempted to conceive during the follow-up period， and four patients succeeded. Conclusions： TLRT is an effective and safe procedure for patients with early-stage cervical carcinoma who want to preserve fertility. A large prospective study is needed to confirm our data.

Key words: Uterine cervical neoplasms, Neoplasms, squamous cell, Fertility, Laparoscopes, Hysterectomy