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新辅助化疗后经阴道根治性宫颈切除术和腹腔镜盆腔淋巴结切除术治疗 IB1 期宫颈癌的长期疗效:系列 60 例。

Long-term outcomes of radical vaginal trachelectomy and laparoscopic pelvic lymphadenectomy after neoadjuvant chemotherapy for the IB1 cervical cancer: A series of 60 cases.

机构信息

Department of Obstetrics and Gynecology, Hainan Branch of PLA General Hospital, Sanya, PR China.

Department of Obstetrics, The General Hospital of Jinan Military Command, Jinan, PR China; Department of Obstetrics and Gynecology, PLA General Hospital, Beijing, PR China.

出版信息

Int J Surg. 2016 May;29:38-42. doi: 10.1016/j.ijsu.2016.03.019. Epub 2016 Mar 11.

Abstract

OBJECTS

The present study sought to analyze the long-time clinical outcomes of the stage IB1 cervical cancer patients who had received the radical vaginal trachelectomy (RVT) and laparoscopic lymphadenectomy after neoadjuvant chemotherapy (NACT).

METHOD

This is a prospective study of 60 patients potentially selected for RVT for a clinical and radiologic cervical cancer (stages IB 1) less than 2 cm. These patients were treated with surgery combined with preoperative NACT in the Department of Obstetrics and Gynecology, PLA General Hospital. We collected the patients' general clinical information, surgical characteristics and obstetric data, and then assessed their long-term oncological outcomes.

RESULTS

The average operative time of the enrolled cases was 204 min and the average blood loss was 443 mL. The average postoperative hospitalization time was 10.6 days. The postoperative pathologic results indicated that the average parametrical width was 1.99 cm; the average length of removed of cervical was 2.6 cm; the average number of excised pelvic lymph node was 20. The median of the follow-up was 43 months (range between 13month and 12 years). Only one case of recurrence was found. Thus far, totally 42 women had tried to conceive, and 36 of them had live births. The live birth pregnancy rate was 86% (36/42).

CONCLUSION

The radical vaginal trachelectomy in combination with the laparoscopic lymphadenectomy surgical is a safe and effective therapeutic strategy for the for IB 1 cervical cancer.

摘要

目的

本研究旨在分析接受新辅助化疗(NACT)后根治性阴道子宫颈切除术(RVT)和腹腔镜淋巴结切除术的 IB1 期宫颈癌患者的长期临床结果。

方法

这是一项前瞻性研究,共纳入 60 例潜在适合 RVT 的临床和影像学宫颈癌(IB 期 1 期)患者,肿瘤直径小于 2cm。这些患者在解放军总医院妇产科接受手术联合术前 NACT 治疗。我们收集了患者的一般临床信息、手术特点和产科数据,然后评估了他们的长期肿瘤学结果。

结果

纳入病例的平均手术时间为 204 分钟,平均出血量为 443 毫升。平均术后住院时间为 10.6 天。术后病理结果显示,平均宫旁宽度为 1.99cm;切除宫颈的平均长度为 2.6cm;切除的盆腔淋巴结平均数量为 20 个。中位随访时间为 43 个月(13 个月至 12 年)。仅发现 1 例复发。迄今为止,共有 42 名妇女尝试怀孕,其中 36 名成功分娩。活产妊娠率为 86%(36/42)。

结论

RVT 联合腹腔镜淋巴结切除术是治疗 IB1 期宫颈癌的一种安全有效的治疗策略。

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