| Objective: Patients with cervical cancer who can usually be offered either operationtherapy or radiation therapy,which is choosed by diffusion range of tumour. Shorttreatment time, resection of the primary lesions, less tissue injury,and selectivelypreserving ovarian and fertility function are advantagesof surgical therapy.radiationtherapy can cure tumour which metastasize to bladder,rectum and others parts,but itmay danmage those function.Therefore, surgical therapy is used to early cervicalcancer,while radiation therapy is used to advanced cervical cancer.abdominal radicalhysterectomy and abdominal pelvic lymph nodes dissection are standard operation ofearly cervical cancer.Due to the rise of minimally invasive surgery and laparoscopictechnology widespread application, a lot of gynecological malignant tumor treatmentcan also be done through laparoscopic surgery.With the development of the concept ofminimally invasive, transformation of the people idea, the laparoscopic technique in theworld rapid development and gradually popularization,Especially, laparoscopicsurgery obtained very good effect in early cervical cancer treatment.Total laparoscopicradical hysterectomy, TLRH and laparoscopic pelvic lymph nodes dissection, LPL arecommon operation method.At present,many hospitals at home and abroad have carriedout such an operation, and report their findings, howerver,there is differences betweentheir finding,because of different hospital conditions and technology levelof doctors.The purpose of our hospital carried out the research as follow: Comparing two kinds ofoperation mode of patients who have cervical cancer of Ⅰ a2Ⅱ b phase, it isabdominal radical hysterectomy and abdominal pelvic lymph nodes dissectionwide,Total laparoscopic radical hysterectomy laparoscopic open and laparoscopic pelviclymph nodes dissection,whose e recent curative effect and prognosis.Then we expoundthe superiority of laparoscopic surgery for cervical cancer early,and provide objectivebasis for security and feasibility of laparoscopic surgery treatment of early cervicalcancer. Methods：Data of63patients with Ⅰa2-Ⅱb cervical cacer who underwent ARH andTLRH were retrospectively collected. A total of63radical hysterectomy procedureswere performed during the study period at our hospital between April2007and March2012，31open(ARH),32laparoscopic (TLRH). All patients involved in the study hadtheir initial pathologic diagnosis confirmed at our institution.In our study31patients inARH group (mean age44±8years mean weight59.86±8.03kg),FIGO stage included4patients withⅠa2,9patients withⅠb1,12patients withⅠb2,1patients withⅡa and5patients with Ⅱb. Histological types included squamous cell carcinoma has29patients,adenocarcinomas is1patients, and adenosquamous carcinoma is one. In TLRH group(mean age45±9years,mean weight61.05±9.36kg),3patients areⅠa2,2patients are Ⅱa,10patients areⅠb1,13patients areⅠb2and4patients areⅡb2. squamous cellcarcinoma has30patients, adenocarcinomas is1patients, and adenosquamouscarcinoma is one. There were no differences in age, body mass index and clinical stagefactors between the groups(P>0.05).Comparison was made between laparoscopic andopen procedures in regard to surgical times, estimated blood loss, the recovery time ofbowel function，time to resumption of normal bladder function，perioperative numberand status of lymph nodes obtained，complication rates, and pathologic findings.Results：In both groups, The successful rate of operation was100%.No importantorgans are injuried during the operation，and there is not case in research group wasconverted into the open-operation. The operating time of research group was(343.87±72.88)min，and that of control group was （309.96±90.07）min，and there were nodifference between two groups (P>0.05). The estimated blood loss in ARH group was（218.75±129.98）ml and TLRH group（680.96±233.15）ml. Estimated blood loss wassignificantly lower in LRH compared with ARH(P<0.05). The mean number of resectedpelvic lymph nodes for the ARH is15±5,the TLRH was17±6,there was no differencebetween them. Recoivery tme of bowel function after operation in ARH group was（68.67±21.05）h and （32.21±6.48）h inTLRH group,there is statistical differencesbetween them.Median length of stay was significantly shorter in TLRH （9.6±5.23d）vs ARH(14.63±4.15d). Recovery time of bladder function for the ARH is18.61±8.39d,the TLRH is14.56±6.26d there is no difference. complication rates were similarbetween two groups. All patients were followed up for11-70months，and there was no tumor recurrence and metastasis puncture．Conclusion：1. Total laparoscopic radical hysterectomy is a safe and effective therapeutic procedurefor the management of early stage cervical cancer.2. The estimated blood loss in the operation is significantly less in TLRH group than inARH group.3. Recovery time of postoperative bowel function for TLRH group was muchshorter than that for ARH group.4. in our study the laparoscopic route is associated with a decrease of the length of stayin hospital.5. There was same operative effect in operative range between TLRH group and ARHgroup.6. We did not found the tumor recurrence and metastasis inTLRH group and ARHgroup during follow-up. |
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