Comparison Of Clinical Efficacy Of LRH And ORH In The Treatment Of Early Cervical Cancer

BackgroundCervical cancer(CC)is one of the most common malignant tumors in gynecological women,and it is also a disease with high morbidity and mortality in women worldwide.In recent years,its incidence rate has shown an obvious younger trend,which has seriously affected the lives and health of millions of women around the world.According to international guidelines,surgery is still the preferred treatment option,and radiotherapy and chemotherapy are other major treatments for cervical cancer.For women with early cervical cancer who have no fertility requirements,surgery should be used.Radical cervical cancer surgery is currently the first and most used surgical option,and its 5-year survival period can reach 62% to90%.The surgical approach can be open or minimally invasive surgery.In recent years,the treatment of cervical cancer can be done with both methods,and the treatment effect is similar,until the results of a2018 Study in the New England Journal of Medicine showed that minimally invasive surgery has a worse survival outcome than open surgery.This authoritative authority The results of sexual research have aroused an upsurge of discussion in the field of gynecological tumors,and the controversy between minimally invasive surgery and open surgery has reached its peak.How to choose the correct surgical procedure in clinical practice is still a practical problem that needs to be solved urgently.ObjectiveOpen radical hysterectomy(ORH)or laparoscopic radical hysterectomy(LRH)were performed on patients with early-stage IB1 cervical cancer with a tumor diameter of less than 2cm.By comparing the intraoperative conditions of the two surgical methods,the occurrence of postoperative complications,and the efficacy of postoperative recovery,the clinical value of the two treatment options in early cervical cancer was explored,and this provided a reference for the selection of clinical diagnosis and treatment.MethodsA retrospective analysis of the clinical data of 85 patients with stage IB1 cervical cancer with a tumor diameter of less than 2cm who underwent laparotomy or laparoscopic radical resection in the Department of Gynecology of Henan Provincial People’s Hospital and the First Affiliated Hospital of Henan University from January 2017 to June 2020,all patients were diagnosed as cervical cancer by imaging and pathology.According to the different surgical routes,they were divided into two groups.Group A was a laparoscopic radical cervical cancer surgery group with 40 cases,and Group B was an open radical cervical cancer surgery group with 45 cases.Collect the patient’s general preoperative clinical data,surgery-related index data,postoperative recovery and complications related data,and collect scale data in the form of questionnaires.On the premise of comparability of baseline data,the two groups were compared for statistical analysis.Results1.The general data of patients in groups A and B: age,BMI,underlying disease,physical status,ECOG score,personal history and pathological classification were not statistically significant(P>0.05).2.Surgery-related and perioperative indicators of patients in groups A and B: operation time,hospitalization costs,intraoperative blood loss,intraoperative blood transfusion rate,pain VAS score,postoperative time to get out of bed,postoperative gastrointestinal exhaust time The difference in postoperative hospital stay was statistically significant(P<0.05);there was no difference in intraoperative ureteral injury,intraoperative ureteral stent placement,24 h drainage,drainage tube removal time,indwelling catheter time,and total hospital stay statistically significant(P>0.05).3.Indexes of postoperative complications related to patients in groups A and B: postoperative nerve injury and lymphatic cysts were statistically different(P<0.05);There was no significant difference in postoperative urinary retention,intestinal obstruction,poor healing of incisions,severe infection,lower extremity venous thrombosis,unplanned readmission,and unplanned reoperation(P>0.05).4.Serum tumor markers of patients in groups A and B: there was no significant difference in the levels of SCC-Ag and CA125 between the two groups before surgery(P>0.05);the levels of SCC-Ag and CA125 in both groups after surgery compared with preoperatively,there was a significant decrease,and the difference was statistically significant(P<0.05);there was no statistically significant difference in the levels of SCC-Ag and CA125 between the two groups after the operation(P>0.05).5.Postoperative quality of life scores and pelvic floor function recovery of patients in groups A and B: There are statistical differences in the quality of life scores of FACT-G cancer patients at 6 month after surgery(P < 0.05);Six months after surgery,the scores of PFDI-20(Pelvic floor dysfunction questionnaire)included POPDI-6(pelvic prolapse),CRADI-8(bowel dysfunction),and UDI-6(urination dysfunction)questionnaires have statistical significance(P<0.05).Conclusions1.Laparoscopic radical resection of cervical cancer treatment of early-stage IB1 cervical cancer with a tumor diameter of less than 2cm can reduce the risk of intraoperative bleeding,lower blood transfusion rate,early gastrointestinal exhaust time,less occurrence of lymphatic cysts after surgery,the postoperative hospital stay is short.But the surgeon’s technical and medical equipment requirements are high,but the operation time and economic costs have increased significantly.2.Open radical resection of cervical cancer for the treatment of early-stage IB1 cervical cancer with a tumor diameter of less than 2cm,with large trauma,obvious pain,get out of bed late after surgery,more drainage,and easy occurrence of complications such as lymphatic cysts,But nerve damage rarely occurs,and the treatment cost is low.3.Plasma Scc-Ag and CA125 levels were significantly reduced in the laparoscopy group and the laparotomy group at 3 months after the operation,indicating that the two surgical methods have obvious effects on the treatment of cervical cancer,and the curative effect is equivalent in the short term.However,the postoperative quality of life and pelvic floor function of patients in the endoscopic group were inferior to those in the open group.