浸润性宫颈癌的根治性子宫切除术。迈阿密技术的25年前瞻性经验。
Radical hysterectomy for invasive cervical cancer. A 25-year prospective experience with the Miami technique.
作者信息
Averette H E, Nguyen H N, Donato D M, Penalver M A, Sevin B U, Estape R, Little W A
机构信息
Department of Obstetrics and Gynecology, University of Miami School of Medicine, FL 33136.
出版信息
Cancer. 1993 Feb 15;71(4 Suppl):1422-37. doi: 10.1002/cncr.2820710407.
BACKGROUND
The Miami modification of the traditional Wertheim-Meigs radical hysterectomy was used to treat Stage IB-IIA cervical cancer in a 25-year prospective study involving 978 patients.
METHODS
The modifications included: vaginal reconstruction and closure using bladder and rectosigmoid serosa, retroperitoneal drainage through abdominal suction catheters, and suspension of the denuded ureters with the ipsilateral obliterated hypogastric artery.
RESULTS
The overall corrected 5-year survival rate was 90.1%, with a surgical mortality rate of 1.4% and an overall urinary fistula rate of 1.4%. This fistula rate was significantly better than a 4.4% incidence rate in a literature survey. Although not measured, the Miami modification appeared to lengthen the vagina.
CONCLUSIONS
Therefore, it was concluded that radical hysterectomy with the Miami modifications can be done safely in most patients with Stage IB-IIA cervical cancer.
背景
在一项涉及978例患者的25年前瞻性研究中，采用迈阿密改良的传统韦特海姆-梅格斯根治性子宫切除术治疗ⅠB-ⅡA期宫颈癌。
方法
改良措施包括：使用膀胱和乙状结肠直肠浆膜进行阴道重建和闭合，通过腹部吸引管进行腹膜后引流，以及用同侧闭塞的下腹动脉悬吊裸露的输尿管。
结果
总的校正5年生存率为90.1%，手术死亡率为1.4%，总的尿瘘发生率为1.4%。该尿瘘发生率明显优于文献调查中的4.4%的发生率。虽然未进行测量，但迈阿密改良似乎延长了阴道。
结论
因此，得出结论，对于大多数ⅠB-ⅡA期宫颈癌患者，采用迈阿密改良的根治性子宫切除术可以安全地进行。
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