Magrina J F
Department of Gynecology, Mayo Clinic Scottsdale, AZ 85259, USA.
J Natl Cancer Inst Monogr. 1996(21):53-9.
Radical hysterectomy and pelvic lymphadenectomy are indicated for the treatment of cervical carcinoma that is localized clinically to the cervix and upper vagina. Intraoperative complications have been reported in 1.1%-7.4% of patients. Long-term complications include bladder dysfunction (2% at 3 years), urinary fistula (vesical, 0.8%; ureteral, 1.2%), stress urinary incontinence (29%), ureteral stricture (1%), rectal dysfunction (80%), severe constipation (5.3%), lymphocysts (20% by ultrasonography; 2% clinically), and lymphedema (10%). The operative mortality is 0.7%. The 5-year survival rate for patients with stage IB disease is 85.7% and for stage IIA is 69.6%. The recurrence rate is 27.2%. Recurrences are distributed equally between the pelvis and extrapelvic sites. Radical hysterectomy is the treatment of choice for pregnant patients with early cervical cancer. It affords termination or delivery of the pregnancy at the same time that the treatment is provided. For patients with stage I disease treated with radical hysterectomy, the survival rate is 92.1%.
根治性子宫切除术和盆腔淋巴结清扫术适用于临床局限于宫颈和阴道上段的宫颈癌的治疗。据报道，1.1%-7.4%的患者会出现术中并发症。长期并发症包括膀胱功能障碍（3年时为2%）、尿瘘（膀胱瘘，0.8%；输尿管瘘，1.2%）、压力性尿失禁（29%）、输尿管狭窄（1%）、直肠功能障碍（80%）、严重便秘（5.3%）、淋巴囊肿（超声检查显示为20%；临床检查显示为2%）和淋巴水肿（10%）。手术死亡率为0.7%。IB期疾病患者的5年生存率为85.7%，IIA期为69.6%。复发率为27.2%。复发在盆腔和盆腔外部位的分布相同。根治性子宫切除术是早期宫颈癌孕妇的首选治疗方法。它在提供治疗的同时能够终止妊娠或分娩。对于接受根治性子宫切除术治疗的I期疾病患者，生存率为92.1%。
