沈扬,徐寒子,冷文淑,吴强
SHEN Yang,XU Hanzi,LENG Wenshu,WU Qiang

• 1:南京医科大学附属肿瘤医院江苏省肿瘤医院妇科肿瘤科
• 2:南京医科大学附属肿瘤医院江苏省肿瘤医院放疗科

摘要(Abstract)：

目的:评价宫颈腺癌患者全量放疗后行筋膜外全子宫切除术的安全性和临床价值。方法:全量放疗后行筋膜外全子宫切除的宫颈腺癌患者28例作为宫颈腺癌组,并取同期由于其他良性疾病行全子宫及双附件切除术患者28例为对照组,观察两组患者手术时间、术中出血量、腹部切口愈合情况及并发症,观察宫颈腺癌患者术中盆腹腔粘连情况、术后肿瘤残留及肿瘤复发情况。结果:两组患者手术时间、术中出血量、腹部切口愈合情况及并发症发生率比较,差异均无统计学意义(P> 0. 05),宫颈腺癌组患者术后病理检查结果提示肿瘤残留17例、占60. 7%,3年肿瘤复发率7. 14%。结论:宫颈腺癌根治性放疗后行筋膜外全子宫切除安全可行,不良反应少,可获得良好的治疗效果。
Objective: To evaluate the safety and clinical value of extrafascial hysterectomy after radical radiotherapy in patients with adenocarcinoma of the uterine cervix( AUC). Methods: Retrospective analysis was used to analyze the clinical data of 28 patients with AUC who underwent extrafascial hysterectomy after radical radiotherapy from 2012 to 2014 in Jiangsu Cancer Hospital,China. The intraoperative and postoperative complications and tumor residuals were analyzed and evaluated about the safety and clinical significance. Results: The average operation time of the 28 patients was 102. 0 minutes. The average blood loss was 165. 4 ml. There was no side injury during surgery. One patient delayed incision healing. One patient developed bladder vaginal fistula for 2 months after surgery,and improved after conservative treatment. Postoperative pathology indicated that 17 cases of tumor residuals,accounting for 60. 7%,and the 3-year tumor recurrence rate was 7. 14%. Conclusion: The treatment of AUC with extrafascial hysterectomy after radical radiotherapy is safe and effective with fewer adverse reactions and better therapeutic effect.

关键词(KeyWords)： 宫颈肿瘤;腺癌;妇科外科手术;放射疗法;子宫切除术
uterine cervix neoplasms;adenocarcinoma;gynecological surgery;radiotherapy;hysterectomy

Abstract:

Keywords:

基金项目(Foundation): 2015六大人才高峰D类资助项目(2015-WSW-043)

作者(Author): 沈扬,徐寒子,冷文淑,吴强
SHEN Yang,XU Hanzi,LENG Wenshu,WU Qiang

DOI: 10.19367/j.cnki.1000-2707.2018.12.023

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