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目的探讨腹腔镜盆腔淋巴切除+阴式广泛全子宫切除术(LPL+VRH)治疗早期子宫恶性肿瘤的临床价值。方法2003年8月至2007年12月,选择11例早期子宫颈癌和8例子宫内膜癌的患者行LPL+VRH治疗(研究组),选取同时入院接受开腹子宫广泛切除+淋巴切除术治疗早期子宫颈癌11例、子宫内膜癌8例为对照组,对其手术情况、手术时间、术后并发症、术中出血量、淋巴结切除数目、术后病率进行比较。结果研究组19例中18例成功手术,1例因淋巴结切除困难中转开腹。研究组与对照组在术中出血[(321.08±284.36)mL,(513.62±237.23)mL]、术后胃肠恢复时间(1.5d,4.5d)、术后下床活动时间(2d,7d),两组间比较差异有统计学意义(P<0.05)。而两组在手术时间、术中清除淋巴结数、术后尿潴留、尿失禁、淋巴囊肿及术后复发等指标上差异无统计学意义(P>0.05)。结论LPL+VRH可作为早期子宫恶性肿瘤手术治疗方法之一,近期效果良好,远期疗效有待进一步观察。
Objective To investigate the clinical value of laparoscopic pelvic lymphadenectomy + vaginal extensive hysterectomy (LPL + VRH) in the treatment of early stage uterine malignancies. Methods From August 2003 to December 2007, 11 cases of early cervical cancer and 8 cases of endometrial cancer were treated with LPL + VRH (study group). All patients undergoing open radical hysterectomy and lymphadenectomy Treatment of early cervical cancer in 11 cases, 8 cases of endometrial cancer control group, its operation, operation time, postoperative complications, intraoperative blood loss, lymph node dissection number, postoperative morbidity were compared. Results In the study group, 18 cases were successfully operated in 19 cases, and 1 case was converted to laparotomy due to difficulty in lymphadenectomy. (321.08 ± 284.36) mL, (513.62 ± 237.23) mL], postoperative gastrointestinal recovery time (1.5d, 4.5d) and postoperative ambulation time (2d, 7d) in the study group and the control group, , The difference between the two groups was statistically significant (P <0.05). There was no significant difference between the two groups in the operation time, the number of lymph nodes removed, urinary retention, urinary incontinence, lymphatic cyst and postoperative recurrence (P> 0.05). Conclusion LPL + VRH can be used as one of the surgical methods for the treatment of early stage uterine malignancies. The recent results are good and the long-term therapeutic effect needs to be further observed.