The Studies Of Meta Analysis,Clinical Research In The Laparoscopic Nerve-sparing Radical Hysterectomy In Cervical Cancer

The safety and satisfactory recovery of voiding function of nerve-sparing radical hysterectomy has been sured, the technique of for performing laparoscopic radical hysterectomy and pelvic lymphadenectomy for more than2decades,it has been generally accepted. laparoscopy may allow better visualization of the retroperitoneal structures and better identification of important nerve structures of the pelvic autonomic nerves. It is especially due to the enlargement achieved by modern video-optical systems with digital zoom function, so it has superiority in sparing pelvic nerve,LNSRH is a new operation mode emboding the humanized, its aim to improve quality of life without compromising oncological outcomes.Since the first LNSRH, gynecological oncologists innovate the techniqer cerselessly and assess the feasibility and safety of the procedure, as well as its impact on voiding function.This research is divided into two parts:(1). laparoscopic nerve-sparing radical hysterectomy versus laparoscopic radical hysterectomy for the treatment of early cervical cancer:A meta-analysis.(2) A comparison of laparoscopic nerve-sparing radical hysterectomy and laparoscopic radical hysterectomy in treatment of early cervical cancer. Objective To assess the efficacy and safety of laparoscopic nerve-sparing radical hysterectomy (LNSRH) in treatment of early cervical cancer. Method Search literature about laparoscopic nerve-sparing radical hysterectomy and laparoscopic radical hysterectomy from CBM、CENTRAL、MEDLINE、 Cochrane library、EMBASE、CNKI. Assess the radical、safety of LNSRH, as well as its impact on voiding function.Choose Review Mananger5.1as the statistical method.For homogeneous studies, we performed meta—analysis. Results Total7studieds a total of506cases were selected, of which a total of255cases LNSRH group, LRH group in251cases. Patients in each group of age, body mass index, clinical stage, histological type and histological grade were not statistically different aspects.1.The operative time of LNSRH is longer than LRH (P=0.02); And there is no significant difference between the two kind of surgery in blood loss(P=0.69).2. Length of dissected parametria of LNSRH is shorter than LRH (P=0.0010). And there is no significant difference in length of dissected vaginal (P=0.38).3. there is no significant difference between the two kind of surgery of the number of intraoperatie lymph node dessection (P=0.09).4. Intestinal function recovery time postoperative of LNSRH is shorter than LRH (P=0.03).5. Recovery of bladder function of LNSRH is better than LRH (P<0.00001). Conclusions The results of this system review show that, the technique of LNSRH appears to be safe, feasible, with satisfactory recovery of voiding function, it can prove the quality of life of patients.It is a new mode of operation with better clinic prospects. But to carry out a short time, we are lack of multi-center, large sample, prospective controlled studies currently,its radical, long-term recurrence rate, survival,etc,are not yet conclusive. The next in-depth study is to conduct more higher quality clinical research to provide important dataes of LNSRH and LRH compared with each other. Objiective To study the feasibility of laparoscopic pelvic autonomic nerve-plane sparing radical hysterectomy(LNSRH)technique and its effect on decreasing postoperative bladder dysfunction. Methods Between January2010and December2011,60consecutive patients with cervical cancer were divided into LNSRH group and LRH group in Guangxi Tumor Hospital.we performed30laparoscopic pelvic autonomic nerves-plane sparing radical hysterectomy with the fascia space dissection technique and according to the basic anatomic landmarks of pelvic autonomic nerves and the operating time, operating bleeding and the postoperative recovery of bladder function were assayed. Results (1)Of all the60patients were performed successfully. The mean operation time was longer in the LNSRH group (P=0.00), No significant differences were observed in terms of the quantity of mean intraoperative blood loss, the recovery time of bowel, numbers of pelvic lymph nodes resected, extent of parametrium and vagina resection between the two groups (P>0.05). The duration of postoperative hospital stay were better in the LNSRH group (P=0.00).(2) The mean time of catheter removed were(10.60±3.20)d,(7—16d)and(17.60±3.21)d,(14—21d)respectively (P=0.00).All patients were followed up for3—19months and no patient died. There were no local recurrence and no matastatic in the two groups.Conclusion The technique described in this study is not only minimal invasive, but is also safe, adequate, and feasible in our population with satisfactory recovery of voiding function.It can improve the quality of life of patients with cervical cancer.