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我院1973～1985年作宫颈癌根治术441例,其中84例术时进行切除范围的测量。Ⅰ_b期42例,Ⅱ_a期36例,Ⅱ_b期6例。切除主韧带8～14cm~2,宫骶韧带12～19cm~2,阴道旁2.5～5.9cm~2,阴道2～3.5cm。5年、10年存活率较多切除者高,即切除范围扩大存活率未见增加而略有降低。但经统计学检验差异无显著性(P均>0.05)。提示上述切除范围对Ⅰ_b期、Ⅱ_a期是合适的。本组随访率100.0％。5年存活率94.05％,其中Ⅰ_b期95.24％,Ⅱ_a期94.44％,Ⅱ_b期5/6。术后尿潴留占11.91％(10/84),输尿管阴道瘘占2.38％(2/84)。本文对手术合适的切除范围、降低术后并发症、提高对淋巴结转移的疗效及Ⅱ~b期手术问题进行了讨论。
In our hospital from 1973 to 1985, 441 cases of cervical cancer were treated with radical mastectomy, of which 84 cases underwent resection range measurement. There were 42 cases in I b stage, 36 cases in II a stage, and 6 cases in II b stage. Resection of the main ligament 8 ~ 14cm ~ 2, uterine ridge ligament 12 ~ 19cm ~ 2, 2.5 ~ 5.9cm ~ 2 vaginal, vaginal 2 ~ 3.5cm. The five-year and ten-year survival rates were higher in the resection group, that is, the survival rate of the resection range did not increase but decreased slightly. However, statistically significant differences were not found (P>0.05). It is suggested that the above scope of resection is suitable for phase I_b and phase II_a. The follow-up rate of this group was 100.0%. The five-year survival rate was 94.05%, including 95.24% of I_b phase, 94.44% of II_a phase, and 5/6 of II_b phase. Postoperative urinary retention accounted for 11.91% (10/84), and ureteral fistula accounted for 2.38% (2/84). This article discusses the appropriate range of surgical resection, the reduction of postoperative complications, the improvement of the efficacy of lymph node metastasis, and the surgical problems in stage II-b.