微创医学

目的探讨新辅助化疗联合腹腔镜下广泛全子宫切除、盆腔淋巴结清扫治疗局部晚期宫颈癌的临床疗效。方法局部晚期宫颈癌患者76例，根据治疗方法分为腹腔镜组和开腹组。腹腔镜组40例新辅助化疗后行腹腔镜下广泛全子宫切除+盆腔淋巴结清扫术+腹主动脉淋巴结清扫术；开腹组36例新辅助化疗后给予经腹广泛子宫切除术+盆腔淋巴结清扫术+腹主动脉淋巴结清扫术。结果新辅助化疗的总有效率为89.47%。两组年龄、分期、病理分级无统计学差异（P＞0.05）。腹腔镜组术中出血量、下床活动时间、肛门排气时间、住院时间均少于开腹组，两组比较，差异有统计学意义（P＜0.05）；两组淋巴结清扫数量、手术时间、切口感染率比较，差异无统计学意义（P＞0.05）。结论新辅助化疗联合腹腔镜下广泛子宫切除术治疗局部晚期宫颈癌疗效满意，安全可行。

ObjectiveTo explorethe clinical effect of neoadjuvant chemotherapy combined with laparoscopic hysterectomy and pelvic lymph node dissection in the treatment of locally advanced cervical cancer. MethodsA total of 76 patients with locally advanced cervical cancer were divided into laparoscope group and laparotomy group according to therapeutic methods. Forty cases in laparoscope groupreceived laparoscopic hysterectomy and pelvic lymphadenectomy after neoadjuvant chemotherapy; 36 patients in laparotomy group received trans-abdominal massive hysterectomy and pelvic lymphadenectomy after neoadjuvant chemotherapy. ResultsThe total effective rate of neoadjuvant chemotherapywas 89.47%. There were not significant difference in age of patients, cancer stage and pathological grade between the two groups(P＞0.05). Intraoperative blood loss, ambulation time, anal exhaust time, hospitalization time of laparoscope group were less than those of control group, the differences were statistically significant (P＜0.05). Therewere not significant differences in the number of lymph nodes, operation time, incision infection rate between the two groups(P＞0.05). ConclusionNeoadjuvant chemotherapy combined with laparoscopic hysterectomy in the treatment of locally advanced cervical cancer is satisfactory, safe and feasible.