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[目的]探讨膀胱截石位时取脐下正中小切口行宫颈癌根治术治疗早期宫颈癌的临床结果。[方法]150例Ⅰa2~Ⅱa期宫颈癌患者,均开腹行广泛全子宫切除术加盆腔淋巴结清扫术及腹主动脉旁淋巴结取样术。其中67例行膀胱截石位,切口位于脐下,称为截石位手术(lithotomy position operation,LPO)组,83例行水平仰卧位,切口绕脐左上,称为仰卧位手术(supine position operation,SPO)组,进行临床相关指标的对比分析。[结果]LPO组淋巴结清扫数目和SPO组相当,切口长度、手术时间和出血量明显少于SPO组,有显著性差异(P<0.05);LPO组与SPO组术后相比,肛门排气时间和下床活动时间早,有显著性差异(P<0.05)。LPO组没有发现膀胱截石位相关并发症的发生。[结论]膀胱截石位时行脐下正中小切口完全能够满足包括腹主动脉旁淋巴结取样术在内的宫颈癌根治术的要求,手术创伤小、恢复快,安全可行,临床疗效明显优于传统仰卧位手术,对早期宫颈癌手术的近期疗效具有显著的优越性。
[Objective] To investigate the clinical results of cervical cancer undergoing primary cervical incision under the median incision of bladder under lithotomy. [Method] 150 cases of patients with stage Ⅰa2 ~ Ⅱa cervical cancer were performed extensive hysterectomy combined with pelvic lymph node dissection and abdominal aortic lymph node sampling. Sixty-seven patients underwent a lithotomy position under the umbilicus, referred to as the lithotomy position operation (LPO) group. Of the 83 patients, the supine position operation was performed in 83 supine position with the incision around the navel, which was called supine position operation , SPO) group, comparative analysis of clinically relevant indicators. [Results] The number of lymph node dissection in LPO group was similar to that in SPO group, and the length of incision, operation time and bleeding volume were significantly less than those in SPO group (P <0.05). Compared with SPO group, Time and ambulation time as early as possible, there was a significant difference (P <0.05). LPO group did not find the occurrence of bladder-related complications. [Conclusion] The median small incision under the umbilical bladder under lithotomy can completely meet the requirements of radical mastectomy of cervical cancer, including para-aortic lymph node sampling. The surgical trauma is small, the recovery is quick, safe and feasible, and the clinical curative effect is obviously superior to Traditional supine surgery, the early effect of early cervical cancer surgery has significant advantages.