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[早期宫颈癌(IA-IIA期)保留神经技术的根治性手术治疗——我们的及国外经验]

[Radical surgical treatment with nerve-sparing technique in early cervical cancer--stage IA-IIA. Our and foreign experience].

作者信息

Ivanov I

出版信息

Akush Ginekol (Sofiia). 2010;49(2):50-2.

Abstract

INTRODUCTION

We tried to make clear the role of sparing of the autonomous pelvic nerves during radical hysterectomy in cervical cancer stage IA-IIA. We compared the radicality, the possibility to introduce this type of operation, the level of local recurrence, the safety and the survival rate of these patients.

METHODS

We summarized 50 scientific publications in this field. We analyzed the level of local recurrence, survival rate and safety of this surgical technique.

RESULTS

The groups with or without nerve-sparing had comparable parameters and results. The sparing of the autonomous pelvic nerves from unilateral or bilateral part of the pelvis was possible in 70-85% of the patients. We found local recurrences in 5% without nerve-sparing operations and in 9,1% in radical hysterectomies with nerve sparing technique. Local recurrences in the group without sparing the nerve inervation appeared after 24 months, and in the group with nerve-sparing technique after 21 months. The duration of the operation and the blood loss were less in the group with nerve-sparing technique. The death and survival rate in both groups were equal.

CONCLUSIONS

As a result of our literature review and our own experience we consider that the sparing of the autonomous pelvic nerves in radical hysterectomies in early cervical cancer can be applied without problems and safely.

摘要

引言

我们试图明确在IA-IIA期宫颈癌根治性子宫切除术中保留自主盆腔神经的作用。我们比较了这种手术方式的根治性、开展该类手术的可能性、局部复发水平、安全性以及这些患者的生存率。

方法

我们总结了该领域的50篇科学出版物。我们分析了这种手术技术的局部复发水平、生存率和安全性。

结果

保留神经组和未保留神经组的参数和结果具有可比性。70%-85%的患者能够单侧或双侧保留盆腔自主神经。我们发现在未保留神经的手术患者中局部复发率为5%,在采用保留神经技术的根治性子宫切除术中局部复发率为9.1%。未保留神经组的局部复发在24个月后出现,而保留神经技术组在21个月后出现。保留神经技术组的手术时间和失血量较少。两组的死亡率和生存率相同。

结论

基于我们的文献综述和自身经验,我们认为在早期宫颈癌根治性子宫切除术中保留自主盆腔神经可以安全、顺利地应用。

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