Arispe Claudia, Pomares Ana Isabel, Santiago Javier De, Zapardiel Ignacio
Gynecologic Oncology Department, La Paz University Hospital, Madrid, Spain.
Chin J Cancer Res. 2016 Apr;28(2):215-20. doi: 10.21147/j.issn.1000-9604.2016.02.09.
The radical hysterectomy (RH) surgical technique has improved along the years. It is used for the treatment of cervical cancer, endometrial cancer when affecting the cervix, and upper vaginal carcinomas. Our aim was to describe the historical evolution of the technique after the introduction of laparoscopy at our institution.
We performed a retrospective review of medical records of patients who underwent RH, grouped in three periods according to the year of surgery: 1990-1999, 2000-2009 and 2010-2013. Patients?characteristics, pathologic details, intraoperative and postoperative complications were analyzed and compared throughout the time periods.
A total of 102 cases of RH were performed at our center during the study period. Among all data collected, the presence of necrosis, age, number of lymph nodes, surgery route, operating time, hospital stay, blood loss and transfusion requirement were statistically significant different among groups. Conversion to laparotomy rate was 19% for the second period compared to the absence of cases in the last one. No significant differences (P=0.124) were observed in the adjuvant treatment received among the three different groups. At the time of the last contact the patients free of disease were 12 (85.7%), 53 (91.3%) and 26 (86.6%) respectively (P=0.406). Regarding the disease-free interval, we found significant better outcomes in the group of laparotomy compared to laparoscopy (P=0.015).
Laparoscopic RH is an acceptable surgery with advantages like magnified vision of the operation field, lower surgical complications, shorter hospital stay and earlier resumption to daily activities.
多年来，根治性子宫切除术（RH）的手术技术不断改进。它用于治疗宫颈癌、累及宫颈的子宫内膜癌以及阴道上段癌。我们的目的是描述在我院引入腹腔镜技术后该技术的历史演变。
我们对接受RH手术的患者病历进行了回顾性研究，根据手术年份将患者分为三个时期：1990 - 1999年、2000 - 2009年和2010 - 2013年。分析并比较了各时期患者的特征、病理细节、术中及术后并发症。
在研究期间，我院共进行了102例RH手术。在收集的所有数据中，坏死情况、年龄、淋巴结数量、手术途径、手术时间、住院时间、失血量和输血需求在各组之间存在统计学显著差异。第二期的剖腹手术转换率为19%，而最后一期无此类病例。在三个不同组中接受的辅助治疗方面未观察到显著差异（P = 0.124）。在最后一次随访时，无病患者分别为12例（85.7%）、53例（91.3%）和26例（86.6%）（P = 0.406）。关于无病生存期，我们发现剖腹手术组的结果明显优于腹腔镜手术组（P = 0.015）。
腹腔镜RH是一种可接受的手术，具有手术视野放大、手术并发症少、住院时间短和能更早恢复日常活动等优点。
