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Taiwan J Obstet Gynecol. 2021 May;60(3):463-467. doi: 10.1016/j.tjog.2021.03.013.
2
Laparoscopic versus open radical hysterectomy in women with early stage cervical cancer: A systematic review and meta-analysis.腹腔镜与开腹根治性子宫切除术治疗早期宫颈癌的系统评价和 Meta 分析。
Taiwan J Obstet Gynecol. 2020 Jul;59(4):481-488. doi: 10.1016/j.tjog.2020.05.003.
3
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Gynecol Minim Invasive Ther. 2019 Aug 29;8(3):91-93. doi: 10.4103/GMIT.GMIT_75_19. eCollection 2019 Jul-Sep.
4
Advances in laparoscopic surgery for cervical cancer.腹腔镜手术治疗宫颈癌的进展。
Crit Rev Oncol Hematol. 2019 Nov;143:76-80. doi: 10.1016/j.critrevonc.2019.07.021. Epub 2019 Aug 2.
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Minimally invasive surgery for early-stage cervical cancer: is the uterine manipulator a risk factor?早期宫颈癌的微创手术:子宫操纵器是一个危险因素吗?
Am J Obstet Gynecol. 2019 Nov;221(5):537-538. doi: 10.1016/j.ajog.2019.07.042. Epub 2019 Aug 5.
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Impact of laparoscopic radical hysterectomy on survival outcome in patients with FIGO stage IB cervical cancer: A matching study of two institutional hospitals in Korea.腹腔镜根治性子宫切除术对 FIGO 分期 IB 期宫颈癌患者生存结局的影响:韩国两家医院的匹配研究。
Gynecol Oncol. 2019 Oct;155(1):75-82. doi: 10.1016/j.ygyno.2019.07.019. Epub 2019 Aug 2.
7
Rates over time and regional variation of radical minimally invasive surgery for cervical cancer: A population based study.宫颈癌根治性微创手术的时间和地域变化率:一项基于人群的研究。
Gynecol Oncol. 2019 Aug;154(2):338-344. doi: 10.1016/j.ygyno.2019.05.019. Epub 2019 Jun 3.
8
Surgical and Oncological Outcome of Total Laparoscopic Radical Hysterectomy versus Radical Abdominal Hysterectomy in Early Cervical Cancer in Singapore.新加坡早期宫颈癌全腹腔镜根治性子宫切除术与根治性腹式子宫切除术的手术及肿瘤学结局
Gynecol Minim Invasive Ther. 2019 Apr-Jun;8(2):53-58. doi: 10.4103/GMIT.GMIT_43_18. Epub 2019 Apr 29.
9
Fertility-sparing surgery for early-stage cervical cancer: does surgical approach have an impact on disease outcomes?早期宫颈癌的保留生育功能手术:手术方式对疾病预后有影响吗?
Am J Obstet Gynecol. 2019 May;220(5):417-419. doi: 10.1016/j.ajog.2019.03.012.
10
Feasibility and outcome of total laparoscopic radical hysterectomy with no-look no-touch technique for FIGO IB1 cervical cancer.无接触无窥视技术行腹腔镜下广泛子宫切除术治疗 FIGO IB1 期宫颈癌的可行性及结局。
J Gynecol Oncol. 2019 May;30(3):e71. doi: 10.3802/jgo.2019.30.e71.

腹腔镜手术与开腹手术对早期宫颈癌淋巴管间隙浸润的影响:一项多中心回顾性研究

The Impaction of Laparoscopic versus Laparotomy for Lymphovascular Space Invasion of Early Cervical Cancer: A Multicenter Retrospective Study.

作者信息

Huang Wei, Wang Yina, Yang Fanchun, Luo Ning, Ai Guihai, Wu Yuliang, Cheng Zhongping

机构信息

Department of Gynecology and Obstetrics, Tenth People's Hospital Affiliated to Tongji University, Yancheng, China.

Department of Gynecology and Obstetrics, Yancheng Third People's Hospital, Yancheng, China.

出版信息

Gynecol Minim Invasive Ther. 2022 Feb 14;11(1):17-22. doi: 10.4103/GMIT.GMIT_121_20. eCollection 2022 Jan-Mar.

DOI:10.4103/GMIT.GMIT_121_20
PMID:35310130
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8926048/
Abstract

OBJECTIVES

The aim of this study was to compare the lymphovascular space invasion between laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH).

MATERIALS AND METHODS

One retrospective study was conducted with 391 patients treated with 242 patients underwent ARH and 149 patients underwent LRH between May 2010 and August 2019. We collected clinicopathological and perioperative outcome from medical records. We adopt Student's -test and Chi-square test was used to compare continuous and categorical variables between LRH and ARH.

RESULTS

Our research found that there was no difference in tumor size, histology, pathology grades, positive lymph nodes, and postoperative complications between LRH and ARH ( > 0.05). The estimated blooding loss (EBL) and length of postoperative hospital stay were less for LRH than ARH (248.12 ml vs. 412.56 ml, < 0.05, and 10.48 days vs. 15.16 days, < 0.05). The mean operative time was longer for LRH than ARH (227.51 min vs. 215.62 min, < 0.05). Significant difference was found in intraoperative complications ( < 0.05). However, LVSI was higher for LRH than ARH (36.8% vs. 19.8%, < 0.05). We discovered that the LVSI was related with International Federation of Obstetrics and Gynecology stage and tumor size.

CONCLUSION

Compared to ARH, the LRH would be advantageous for early cervical cancer in terms of EBL, length of postoperative hospital stay, and intraoperative complications. The ARH was superior to LRH in operative time. In addition to, LRH was more likely to lead to LVSI. Furthermore, when tumor size or stage was increasing, LRH was easily to generate LVSI. But, we cannot confirm recurrence rate is related to LVSI.

摘要

目的

本研究旨在比较腹腔镜根治性子宫切除术(LRH)与腹式根治性子宫切除术(ARH)之间的淋巴管间隙浸润情况。

材料与方法

进行了一项回顾性研究,纳入2010年5月至2019年8月期间接受治疗的391例患者,其中242例行ARH,149例行LRH。我们从病历中收集临床病理和围手术期结果。采用Student's -检验和卡方检验比较LRH和ARH之间的连续变量和分类变量。

结果

我们的研究发现,LRH和ARH在肿瘤大小、组织学、病理分级、阳性淋巴结和术后并发症方面无差异(>0.05)。LRH的估计失血量(EBL)和术后住院时间比ARH少(248.12 ml对412.56 ml,<0.05,以及10.48天对15.16天,<0.05)。LRH的平均手术时间比ARH长(227.51分钟对215.62分钟,<0.05)。术中并发症存在显著差异(<0.05)。然而,LRH的淋巴管间隙浸润(LVSI)高于ARH(36.8%对19.8%,<0.05)。我们发现LVSI与国际妇产科联合会分期和肿瘤大小有关。

结论

与ARH相比,LRH在EBL、术后住院时间和术中并发症方面对早期宫颈癌更具优势。ARH在手术时间方面优于LRH。此外,LRH更易导致LVSI。而且,当肿瘤大小或分期增加时,LRH更容易产生LVSI。但是,我们不能确定复发率与LVSI有关。