Massi G, Savino L, Susini T
Department of Obstetrics and Gynecology, University of Florence, Policlinico Careggi, Italy.
Am J Obstet Gynecol. 1993 Mar;168(3 Pt 1):928-34. doi: 10.1016/s0002-9378(12)90847-9.
The aim of the current study was to determine the effectiveness of Schauta's vaginal hysterectomy in the treatment of stage IB or IIA cervical carcinoma.
In a retrospective analysis the results of Schauta's operation have been compared with those of Meigs' operation in 793 consecutive cases of stage IB or IIA cervical carcinoma. In 201 of them adjuvant radiotherapy was given. A total of 356 patients with stage IB and 76 with stage IIA underwent Schauta's operation, whereas 288 and 64 patients with stage IB and IIA, respectively, were operated on with Meigs' procedure. For statistical analysis the Mantel-Haenszel test was used.
In stage IB the 5-year survival (Kaplan and Meier method) was 81% in the Schauta group and 75% in the Meigs group (p < 0.05). The results for stage IIA were 68% and 64%, respectively (difference not significant). In a separate analysis for stage IB and treatment by surgery alone, 5-year survival rates for the 283 in the Schauta group and the 175 in the Meigs group were 83% and 78%, respectively (difference not significant).
Schauta's vaginal hysterectomy showed a high rate of cure for stage IB or IIA cervical cancer. Therefore we conclude that it can be used as an alternative to the Meigs operation in the presence of obesity or elevated surgical risk.
本研究旨在确定绍陶氏经阴道子宫切除术治疗ⅠB期或ⅡA期宫颈癌的有效性。
在一项回顾性分析中，将793例连续的ⅠB期或ⅡA期宫颈癌患者的绍陶氏手术结果与梅格斯手术结果进行了比较。其中201例接受了辅助放疗。共有356例ⅠB期患者和76例ⅡA期患者接受了绍陶氏手术，而分别有288例ⅠB期患者和64例ⅡA期患者接受了梅格斯手术。采用Mantel-Haenszel检验进行统计分析。
在ⅠB期，绍陶氏手术组的5年生存率（Kaplan-Meier法）为81%，梅格斯手术组为75%（p<0.05）。ⅡA期的结果分别为68%和64%（差异无统计学意义）。在一项单独的针对ⅠB期且仅接受手术治疗的分析中，绍陶氏手术组的283例患者和梅格斯手术组的175例患者的5年生存率分别为83%和78%（差异无统计学意义）。
绍陶氏经阴道子宫切除术对ⅠB期或ⅡA期宫颈癌显示出较高的治愈率。因此，我们得出结论，在存在肥胖或手术风险升高的情况下，它可作为梅格斯手术的替代方法。
