Li H, Jang J Y, Li H, Chen K, Shao X G
The Second Affliated Hospital of China Medical University, ShenYang, China.
Eur J Gynaecol Oncol. 2012;33(6):601-4.
To evaluate the correlations between postoperative sequelae and the intervals between conization and subsequent laparoscopic radical hysterectomy (LRH) and pelvic lymphadenectomy in patients with cervical cancer.
A retrospective study was conducted in a tertiary care university hospital. The medical records of cervical cancer patients undergoing LRH and pelvic lymphadenectomy between April 2005 and August 2011 were reviewed. The subjects were divided into three groups according to time from conization to LRH: group 1 (within six weeks, n = 17), group 2 (> six weeks, n = 38), and group 3 (no previous conization, n = 40).
The three groups showed no significant differences with respect to patient and tumor characteristics, intraoperative variables such as surgical time, blood loss, conversion to laparotomy, and perioperative morbidity, while the complications in group 1 showed a significant difference compared to groups 2 and 3.
LRH is feasible for the treatment of cervical cancer patients with previous conization and the appropriate time interval is after six weeks. A careful separation of the bladder and ureters from the cervix is recommended to minimize morbidity associated with this surgery.
评估宫颈癌患者锥切术与后续腹腔镜根治性子宫切除术(LRH)及盆腔淋巴结清扫术之间的时间间隔与术后后遗症的相关性。
在一家三级医疗大学医院进行回顾性研究。回顾了2005年4月至2011年8月期间接受LRH及盆腔淋巴结清扫术的宫颈癌患者的病历。根据从锥切术到LRH的时间将研究对象分为三组:第1组(六周内,n = 17),第2组(超过六周,n = 38),第3组(未行过锥切术,n = 40)。
三组在患者和肿瘤特征、手术时间、失血量、中转开腹等术中变量以及围手术期发病率方面无显著差异,而第1组的并发症与第2组和第3组相比有显著差异。
LRH用于治疗既往有锥切术史的宫颈癌患者是可行的,合适的时间间隔是六周后。建议小心地将膀胱和输尿管从宫颈分离,以尽量减少与该手术相关的发病率。