保留神经的广泛子宫切除术对盆脏功能及生活质量的影响：多中心对照研究
Pelvic dysfunctions and quality of life after nerve-sparing radical hysterectomy: a multicenter comparative study.
机构信息
Gynecologic Oncology Division, Department of Obstetrics and Gynecology, International School of Surgical Anatomy, European Gynaecology Endoscopy School, Sacred Heart Hospital, Via Don A. Sempreboni No.5, 37024 Negrar, Verona, Italy.
出版信息
Anticancer Res. 2012 Feb;32(2):581-8.
AIM
To analyze pelvic dysfunctions, quality of life, and survival after nerve-sparing radical hysterectomy (NSRH) compared to classical radical hysterectomy (RH) for cervical cancer.
PATIENTS AND METHODS
All cervical cancer patients undergoing a RH or a NSRH were evaluated for pelvic dysfunctions and filled in a quality-of-life questionnaire.
RESULTS
A total of 56 women were included; 31 underwent RH (group 1) and 25 NSRH (group 2). Postoperatively, a higher number of patients had urinary incontinence (p=0.02), urinary retention (p=0.01), faecal incontinence (p=0.01) and constipation (p=0.01) in group 1 versus group 2. Patients referred a higher rate of severe sexual dysfunction after RH compared to NSRH (p=0.03). No differences were found in orgasmic frequency and sexual desire; overall quality of life evaluation was more satisfactory after NSRH.
CONCLUSION
NSRH conferred a better clinical outcome with fewer long-term bladder, colorectal and sexual complications. Post-operative quality of life after NSRH was better, with the same overall survival as compared to RH.
目的
分析与经典根治性子宫切除术（RH）相比，保留神经的根治性子宫切除术（NSRH）治疗宫颈癌后的盆腔功能、生活质量和生存率。
患者和方法
所有接受 RH 或 NSRH 的宫颈癌患者均评估盆腔功能，并填写生活质量问卷。
结果
共纳入 56 例女性；31 例行 RH（组 1），25 例行 NSRH（组 2）。术后，组 1 中尿失禁（p=0.02）、尿潴留（p=0.01）、粪便失禁（p=0.01）和便秘（p=0.01）的患者多于组 2。与 NSRH 相比，RH 后患者报告严重性功能障碍的比例更高（p=0.03）。两组患者的性高潮频率和性欲无差异；NSRH 后的整体生活质量评估更满意。
结论
NSRH 可减少长期膀胱、结直肠和性功能并发症，具有更好的临床效果。与 RH 相比，NSRH 后的术后生活质量更好，总生存率相同。
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