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根治性阴道子宫颈切除术联合腹腔镜盆腔淋巴结清扫术用于早期宫颈癌年轻女性的生育功能保留

Radical Vaginal Trachelectomy with Laparoscopic Pelvic Lymphadenectomy for Fertility Preservation in Young Women with Early-Stage Cervical Cancer.

作者信息

Brătilă Elvira, Brătilă C P, Coroleuca C B

机构信息

Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; Department of Obstetrics and Gynecology, Clinical Emergency Hospital "Sf. Pantelimon", Sos. Pantelimon, nr. 340-342, Postal code 021659 Bucharest, Romania.

Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; Minimally Invasive Surgery Hospital Euroclinic "Regina Maria", Bucharest, Romania.

出版信息

Indian J Surg. 2016 Aug;78(4):265-70. doi: 10.1007/s12262-015-1351-3. Epub 2015 Sep 28.

Abstract

The primary objective of this study was to describe our experience with the conservative treatment of early-stage cervical cancer (stages IA1, IA2, and IB1) with radical vaginal trachelectomy (RVT) and laparoscopic pelvic lymphadenectomy. This retrospective observational case series included 36 patients with early cervical cancer. Radical trachelectomy and laparoscopic pelvic lymphadenectomy were performed as described by D. Dargent in 32 of these cases. Oncologic, reproductive, and obstetric outcomes were observed subsequently over a median period of 42 (24-96) weeks. A total of 32 RVTs were preformed with a mean operating time of 117 ± 22.8 (77-167) minutes and an average blood loss of 486 mL (150-800 mL). All obtained resection margins were negative for cancer. Lymphovascular space invasion was noted in 11 (30.55 %) of the cases. No recurrences occurred during the study period. Seven (17.8 %) patients were able to become pregnant postoperatively, five of whom delivered healthy infants near term. Radical vaginal trachelectomy with laparoscopic pelvic lymphadenectomy appears to be a safe therapeutic option for fertility preservation in young women with early cervical cancer.

摘要

本研究的主要目的是描述我们采用根治性阴道子宫颈切除术(RVT)和腹腔镜盆腔淋巴结清扫术对早期宫颈癌(IA1期、IA2期和IB1期)进行保守治疗的经验。这项回顾性观察性病例系列研究纳入了36例早期宫颈癌患者。其中32例患者按照D. Dargent所描述的方法进行了根治性子宫颈切除术和腹腔镜盆腔淋巴结清扫术。随后在中位时间42(24 - 96)周内观察肿瘤学、生殖和产科结局。共进行了32例根治性阴道子宫颈切除术(RVT),平均手术时间为117 ± 22.8(77 - 167)分钟,平均失血量为486 mL(150 - 800 mL)。所有切除边缘的癌症检测均为阴性。11例(30.55%)病例发现有淋巴血管间隙浸润。在研究期间未发生复发。7例(17.8%)患者术后能够怀孕,其中5例在接近足月时产下健康婴儿。对于早期宫颈癌的年轻女性,根治性阴道子宫颈切除术联合腹腔镜盆腔淋巴结清扫术似乎是一种安全的保留生育功能的治疗选择。

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