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保留神经的根治性子宫切除术与根治性子宫切除术:一项回顾性研究

[Nerve-sparing radical hysterectomy and radical hysterectomy: a retrospective study].

作者信息

Ju Xing-zhu, Li Zi-ting, Yang Hui-juan, Wu Xiao-hua

机构信息

Department of Gynecologic Oncology, Fudan University Cancer Hospital, Shanghai 200032, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2009 Aug;44(8):605-9.

Abstract

OBJECTIVE

To compare Piver radical hysterectomy (RH) with nerve-sparing radical hysterectomy (NSRH) for cervical cancer patients in terms of postoperative physiology of pelvic autonomic nerve and perioperative complications.

METHODS

Ninety-three consecutive patients with invasive cervical cancer underwent RH (69 cases) or NSRH (24 cases) from March 2005 to March 2006 at Fudan University Cancer Hospital. The postoperative function of bladder, bowel and sexual function and perioperative morbidity were assessed.

RESULTS

Compared with patients received RH, patients underwent NSRH presented a significantly prompter recovery of bladder function (8.7 vs. 14.8 days, P < 0.01) and bowel function (2.9 vs. 3.2 days, P < 0.01). However, there were not significant difference in terms of operative time (146.7 vs. 143.3 minutes, P > 0.05), estimated blood loss (441.7 vs. 565.9 ml, P > 0.05) and hospital stay (10.21 vs. 10.19 days, P > 0.05). No positive surgical margin was found in both groups. No surgery complication was found in NSRH group, while there were 1 case presented the infection of lymphocyst and 1 case presented intestinal obstruction in RH group. After following up postoperative 6 months, the patients received NSRH had a higher rate of satisfaction at sex activity than those received RH (29% vs. 9%, P = 0.042).

CONCLUSION

NSRH is safe and feasible surgical management for cervical cancer patients, which would improved the physiology of pelvic autonomic nerve postoperatively.

摘要

目的

比较广泛性子宫切除术(RH)与保留神经广泛性子宫切除术(NSRH)对宫颈癌患者盆腔自主神经术后生理功能及围手术期并发症的影响。

方法

2005年3月至2006年3月,复旦大学附属肿瘤医院93例连续的浸润性宫颈癌患者接受了RH(69例)或NSRH(24例)手术。评估术后膀胱、肠道及性功能以及围手术期发病率。

结果

与接受RH的患者相比,接受NSRH的患者膀胱功能(8.7天对14.8天,P<0.01)和肠道功能(2.9天对3.2天,P<0.01)恢复明显更快。然而,手术时间(146.7分钟对143.3分钟,P>0.05)、估计失血量(441.7毫升对565.9毫升,P>0.05)和住院时间(10.21天对10.19天,P>0.05)两组间无显著差异。两组均未发现手术切缘阳性。NSRH组未发现手术并发症,而RH组有1例出现淋巴囊肿感染,1例出现肠梗阻。术后6个月随访,接受NSRH的患者性活动满意度高于接受RH的患者(29%对9%,P=0.042)。

结论

NSRH对宫颈癌患者是一种安全可行的手术方式,可改善术后盆腔自主神经生理功能。

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