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目的:比较早期宫颈鳞癌患者腹腔镜宫颈癌根治术(laparoscopic radical hysterectomy,LRH)与开腹宫颈癌根治术(open radical hysterectomy,ORH)的手术并发症的发生情况以及患者的生存情况。方法:回顾性研究2008年1月至2012年12月新疆肿瘤医院收治的IB-IIA期宫颈癌患者ORH和LRH的手术并发症的发生情况及生存情况。结果:ORH组术中出血量明显多于LRH组[(431.15±126.89)m L vs.(141.83±53.12)m L,P<0.001];ORH组淋巴结切除个数明显少于LRH组[(22.91±8.38)枚vs.(26.41±10.24)枚,P<0.001];ORH组和LRH组术中并发症发生率及术后并发症发生率比较无明显统计学意义(P>0.05)。ORH组1、3、5年无病生存率分别为95.08%、87.23%、72.55%;LRH组1、3、5年无病生存率分别为98.80%、89.53%、77.30%,两组术后无病生存差异无统计学意义(P=0.056),但当肿瘤直径≥4 cm时LRH组的无病生存率高于ORH组且差异有统计学意义(P=0.014)。结论:早期宫颈癌患者行腹腔镜下癌根治术时手术并发症少,术后恢复快。对于肿瘤直径≥4 cm的患者采用腹腔镜宫颈癌根治术可能会提高患者无复发生存率。
Objective: To compare the incidence of laparoscopic radical hysterectomy (LRH) with open radical hysterectomy (ORH) and the survival of patients with early cervical squamous cell carcinoma. Methods: The incidence and survival of ORH and LRH in patients with stage IB-IIA cervical cancer admitted to Xinjiang Cancer Hospital from January 2008 to December 2012 were retrospectively studied. Results: The blood loss in ORH group was significantly higher than that in LRH group [(431.15 ± 126.89) m L vs. (141.83 ± 53.12) m L, P <0.001]. The number of resection in ORH group was significantly less than that in LRH group [(22.91 ± 8.38)% vs. (26.41 ± 10.24), respectively, P <0.001]. There was no significant difference in the incidence of postoperative complications and complications between ORH group and LRH group (P> 0.05). The 1, 3, 5 year disease-free survival rate of ORH group was 95.08%, 87.23% and 72.55% respectively. The 1,3 and 5 year disease free survival rates of LRH group were 98.80%, 89.53% and 77.30% The difference in disease-free survival was not statistically significant (P = 0.056). However, the disease-free survival rate in LRH group was significantly higher than that in ORH group (P = 0.014). Conclusions: The complications of laparoscopic radical mastectomy in patients with early stage cervical cancer are less and the postoperative recovery is faster. For patients with tumor diameter ≥ 4 cm, laparoscopic radical mastectomy may increase the recurrence-free survival rate.