Luo Mingyan, Liu Yuyang, Lv Yumei
Western Theater Command General Hospital Chengdu 610083, Sichuan, China.
Am J Transl Res. 2025 Mar 15;17(3):2103-2111. doi: 10.62347/ULEY1927. eCollection 2025.
To evaluate the efficacy and safety of laparoscopic radical hysterectomy (LRH) combined with pelvic lymph node dissection (PLND) in patients with early-stage cervical cancer.
This retrospective study analyzed 58 cases of early cervical cancer who underwent surgical treatment at Western Theater Command General Hospital between January 2019 and September 2020. Patients were divided into two groups based on surgical approach: the observation group (n=26) received LRH and PLND without uterine manipulator, while the control group (n=32) underwent LRH with uterine manipulator and PLND. Clinical data including operative time, intraoperative blood loss, time to first flatus, postoperative hospital stay, number of lymph nodes dissected, and postoperative pain (VAS score at 7 days) were compared between groups. Serum tumor markers (CA125, CA199, CEA, and SCC) were measured and analyzed. Postoperative complications and quality of life were assessed during a 6-month follow-up period. Patients were further categorized into good prognosis (n=40, no recurrence) and poor prognosis (n=18, recurrence) groups based on 1-year follow-up outcomes to identify independent prognostic factors.
The observation group demonstrated significantly better outcomes compared to the control group, including shorter operative time, reduced intraoperative blood loss, earlier return of bowel function, shorter hospital stay, lower postoperative pain scores, and decreased serum tumor marker levels (all P<0.05). The observation group also had a higher number of lymph nodes dissected (P<0.05). Furthermore, this group showed a significantly lower incidence of postoperative complications and better quality of life at 6 months postoperatively (P<0.05). Multivariate analysis identified the number of lymph nodes dissected and surgical approach as independent prognostic factors.
LRH without uterine manipulator combined with PLND demonstrates superior surgical outcomes, reduced complication rates, and improved recovery for patients with early-stage cervical cancer, representing a valuable advancement in clinical practice.
评估腹腔镜根治性子宫切除术（LRH）联合盆腔淋巴结清扫术（PLND）治疗早期宫颈癌患者的疗效和安全性。
本回顾性研究分析了2019年1月至2020年9月在西部战区总医院接受手术治疗的58例早期宫颈癌患者。根据手术方式将患者分为两组：观察组（n = 26）接受无子宫操纵器的LRH和PLND，而对照组（n = 32）接受有子宫操纵器的LRH和PLND。比较两组患者的临床数据，包括手术时间、术中出血量、首次排气时间、术后住院时间、清扫淋巴结数量以及术后疼痛（术后7天的视觉模拟评分法[VAS]评分）。检测并分析血清肿瘤标志物（CA125、CA199、CEA和SCC）。在6个月的随访期内评估术后并发症和生活质量。根据1年随访结果将患者进一步分为预后良好组（n = 40，无复发）和预后不良组（n = 18，复发），以确定独立的预后因素。
与对照组相比，观察组的各项结果均显著更好，包括手术时间更短、术中出血量减少、肠功能恢复更早、住院时间更短、术后疼痛评分更低以及血清肿瘤标志物水平降低（均P < 0.05）。观察组清扫的淋巴结数量也更多（P < 0.05）。此外，该组术后并发症发生率显著更低，术后6个月生活质量更好（P < 0.05）。多因素分析确定清扫淋巴结数量和手术方式为独立的预后因素。
无子宫操纵器的LRH联合PLND对早期宫颈癌患者显示出更好的手术效果、更低的并发症发生率和更快的恢复，是临床实践中的一项重要进展。
