| Objective:To determine the feasibility and excellence of laparoscopic radical hysterectomy in the treatment of cervical cancer. To study the learning curve of total laparoscopic radical hysterectomy with pelvic lymph-adenectomy. To summarize postoperative radiotherapy and analysis recent survival and prognostic.Methods:A retrospective analysis was made on 108 cases with stage Ⅰa～ Ⅱb cervical cancer which accepted laparoscopic radical hysterectomy from June 2011 to June 2014 in department of gynaecology at The First Affiliated Hospital of Chongqing Medical University,all the surgeries were taken by one surgeon. Some indexes were recorded, such as age, height, weight, abdominal surgery history, (2009) FIGO clinical stage, pathological type, operation method, operation time, estimated blood loss, intraoperative complications and postoperative pathology report and adjuvant therapy after surgery. Recent follow-up survival and relapse. Research contents:1) To analysis the feasibility and security and effectiveness of laparoscopic surgery.2) To study the learning curve of total laparoscopic radical hysterectomy with pelvic lymph-adenectomy. according to the operation time, all patients is divided into four groups:group A (26 cases) and group B (26 cases), (25 cases) group C, D group (25 cases) and contrast analysis of operative time and estimated blood loss.3) To summarize postoperative radiotherapy and analysis recent survival and prognostic.Results:1. General situation:108 cases operations were successfully performed under laparoscopy. Success rate was 100.0%. No patient had positive surgical margin. Intraoperative complications rate was 0.9%(1/108).2. The learning curve of total laparoscopic radical hysterectomy with pelvic lymph-adenectomy:group A, group B, group C, group D operation time was 208.3±34.4 min,190.7±27.2 min,27.2±36.4 min,188.0±33.8 min,, respectively. the difference between all the groups was statistically significant (P< 0.05).difference between the group A and group B/group C/group D was statistically significant (P< 0.05), the difference between group B and group and group D has no statistical significance (P> 0.05).3. Adjuvant radiotherapy summary:1) the relationship between risk factors of pathology and adjuvant radiotherapy:adjuvant radiation rate without high-risk pathological factors was 0.0%(0/46), adjuvant radiation rate with high-risk pathological factors was 79.0%(49/62).2) the relationship between clinical staging and high-risk pathological factors and the adjuvant radiation:The high risk pathological factors rate and adjuvant radiation rate of stage ⅠA, ⅠB1, ⅡA1 patients at rate was 46.6%(28/60),28.3%(17/60), respectively. The high risk pathological factors rate, adjuvant radiation rate of Stage ⅠB2, ⅡA2, ⅡB patients at rate was 70.8%(34/48),66.7%(32/48), respectively.4. Survival analysis:the median follow-up time was 19 months (range,11-44),1 case of recurrence, the recurrence rate was 0.9%,2 years disease-free survival rate was 98.2%, no deaths, overall survival rate was 100.0%.Conclusion:1 laparoscopic radical hysterectomy is adequate, safe, and feasible for women with cervical cancer for early-stage cervical.2 The learning curve of total laparoscopic radical hysterectomy with pelvic lymph-adenectomy for cervical cancer is about 26 cases.3 Adjuvant radiation refer to high risk of pathological factors is efficient by recent follow-up survival prognosis, but the study is luck of analysis of long-term survival prognosis. |
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