The Clinical Research Of Laparoscopic Nerve-sparing Radical Hysterectomy

Objective To investigate the clinical effects and the impact on bladder and rectal,rectum and sexual function of laparoscopic nerve-sparing radical hysterectomy for cervical cancer.Methods From January2008to December2009,222consecutive patients with invasive cervical cancer were randomly divided into two groups. The study group (112cases) underwent laparoscopic nerve-sparing radical hysterectomy (LNSRH), and the control group (110cases) underwent laparoscopic radical hysterectomy (LRH).The operative time, blood loss, number of lymph nodes removed, extent of parametrium and vagina resection, postoperative catheter removal time, flatus and bowel movement time were compared between in two groups. Morever, the urodynamic results were compared in preoperative and postoperative3months and1year. In addition, the bladder,sexual function in two groups were compared with Incontinence Quality of Life Questionnaire (I-QOL),EORTC QLQ-C30quality of life questionnaire and the female Sexual Function Inventory (FSFI) preoperatively and postoperatively.Results1. No significant differences were observed in terms of mean operative time, blood loss, number of lymph nodes removed and extent of parametrium and vagina resection.2. The mean time of catheter removed, flatus and bowel movement postoperatively in study group was significantly shorter than the control group (P<0.05).3.The differences were statistically significant with urodynamic findings including maximum flow rate, maximum detrusor contractility, the bladder capacity and bladder compliance in two groups preoperatively and postoperatively (P<0.05).4.In study group, The operative time of the first30cases was longer than the second30to112cases, the difference was statistically significant (P<0.05).5. The I-QOL score, FSFI score and quality of life were less postoperatively than preoperatively in study group.6.The sexual desire, sexual arousal, vaginal lubrication, orgasm, sexual satisfaction, pain scores and total scores in two groups were decreased postoperatively1year. Compared the two groups, with the exception of sexual desire, the other items and total score differences were statistically significant (P<0.05).7. The incontinence quality of life questionnaire scores were postoperatively less than preoperatively (P<0.05). The Incontinence Quality of Life Questionnaire scores were significantly less postoperatively than preoperatively in two groups.Incontinence Quality of Life Questionnaire score significantly higher postoperatively1year in the study group than the control groups (P<0.05).Conclusion LNSRH for early cervical cancer can significantly improve the quality of life of patients, and less bleeding, less time-consuming short surgical procedures simplified for establishing standard operation, easy application.