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[20例宫颈癌根治性放疗后复发患者行全盆腔脏器切除并保留肛门治疗效果的回顾性分析]

[Retrospective analysis of curative effect of total pelvic organ resection and anal preservation in 20 patients with recurrence of cervical cancer after radical radiotherapy].

作者信息

Wang G C, Gao C Q, Liu Y J, Han G S, Wang Y C, Zhang G Q, Ding L L, Li B, Wang B C, Chang S W

机构信息

Department of General Surgery, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou 450008, China.

Department of General Surgery, Hainan People's Hospital, Haikou 570100, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2020 Mar 23;42(3):242-246. doi: 10.3760/cma.j.cn112152-20190806-00504.

DOI:10.3760/cma.j.cn112152-20190806-00504
PMID:32252204
Abstract

To explore the surgical method and effect of en bloc pelvic resection and anal preservation after radical radiotherapy for cervical cancer. Clinical data of 20 cervical cancer patients with central recurrence after radical radiotherapy underwent en bloc pelvic resection in the Tumor Hospital of Zhengzhou University and Hainan Provincial People's Hospital from January 2013 to December 2017 were retrospectively analyzed. The operative time, intraoperative blood loss, length of stay, postoperative anal function and postoperative complications were evaluated. The median operation time of 20 patients with anal preservation after en bloc pelvic resection was 135.2 min, the median intraoperative blood loss was 680 ml, and the median hospitalization time was 16.5 days. Among them, 18 patients had good postoperative healing, and the anal function gradually returned to normal within 6 months after surgery, defecated 1~2 times per day.One patient showed incomplete adhesion between the external colon and the anus. One patient presented with pre-sacral infection. Postoperative pathology confirmed the recurrences in 20 patients, of which 11 cases were squamous cell carcinoma, 7 cases were adenocarcinoma, 2 cases were adenosquamous cell carcinoma. It is safe and reliable to preserve anus after en bloc pelvic resection for cervical cancer patients with radical radiotherapy. The anus function is good enough to improve the postoperative life quality of patients significantly.

摘要

探讨宫颈癌根治性放疗后盆腔整块切除并保留肛门的手术方法及效果。回顾性分析2013年1月至2017年12月在郑州大学肿瘤医院和海南省人民医院接受盆腔整块切除的20例宫颈癌根治性放疗后中心复发患者的临床资料。评估手术时间、术中出血量、住院时间、术后肛门功能及术后并发症。20例盆腔整块切除并保留肛门患者的中位手术时间为135.2分钟,中位术中出血量为680毫升,中位住院时间为16.5天。其中,18例患者术后愈合良好,术后肛门功能在6个月内逐渐恢复正常,每天排便1~2次。1例患者结肠外置与肛门之间粘连不全。1例患者出现骶前感染。术后病理证实20例均为复发,其中鳞状细胞癌11例,腺癌7例,腺鳞癌2例。对于宫颈癌根治性放疗后患者,盆腔整块切除并保留肛门安全可靠。肛门功能良好,能显著提高患者术后生活质量。

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