The Effect And Evaluation Of Improved Pelvic Peritoneum Suture In Extending The Length Of The Vagina After Radical Hysterectomy

Backgrounds and objectives: Cervical cancer is the most common malignant tumor of the female reproductive system, With the improvement and popularization of the screening technology, The incidence of cervical cancer is increasing year by year, and showing a clear trend of younger. Most of the early patients with cervical cancer have long-term survival after radical surgery. Hysterectomy and pelvic lymph node dissection is the standard surgical procedure for cervical cancer. The scope of the operation is relatively large,there may be some obvious discomfort after surgery, such as the vagina significantly shortened, patients with early menopause symptoms, etc. All of these may affect the quality of life of the patients, especially young patients. In order to seek the solution to the above problems, clinicians continue to trying to transposition of ovary and the vaginal lengthening, and constantly improve the modus operandi. Now, the most frequently used method is vagina replacement by peritoneum, but the operation method is more complicated, and clinical effect of less satisfactory, therefore, in clinical practice, it is very important to find a more convenient and effective method to prolong the vaginal length of cervical cancer after operation. The purpose of this study was to explore the effect and feasibility of improving the vaginal length and improving the sexual life of the patients with cervical cancer after modified pelvic peritoneum suture.Material and Methods: Subject investigated: From January 2012 to June 2014, 52 patients with radical operation of cervical cancer in our hospital,;age: from 26 to 41 years old, the median age of: 38 years old; pathological types: cervical squamous cell carcinoma.; clinical stage(FIGO, 2009): IB1 phase in 38 cases, IB2 phase in 9 cases, IIA phase in 5 cases. Before 2013,traditional pelvic peritoneum was performed in 27 patients(control group), after 2013, 25 cases of modified pelvic peritoneal suture(study group).The two groups were comparable in age, pathological type, clinical stage, preoperative treatment and so on, two groups of patients were underwent ovarian transposition. Then compared their operation condition, vaginal length, sexual life recovery. The measurement data is expressed in "mean plus or minus standard deviation", Count data expressed as a percentage. The statistical methods used in ?2 test, t test, analysis of variance of repeated measurement data. Set a =0.05 for the test level, P<0.05 for the difference was statistically significant, all statistical data were analyzed using SPSS 17 statistical software package.Results:1. Operation conditionTwo groups of operations were successfully completed, the operation was not significantly damaged organs. Statistical data showed that the two groups in the operation time, the amount of bleeding during the operation was not statistically significant(P>0. 05).2. Postoperative conditionsTwo groups were not statistically significant in the postoperative anal exhaust time, catheter retention time, postoperative morbidity, postoperative lymphatic retention cyst incidence rates.(p>0.05)3. Length of the vaginaThroughout the course of the study, we need to measure the length of the vagina 4 times, respectively before operation, 3 months? 6 months?12 months after operation. The average vaginal length of the study group was longer than that in the control group, the difference was statistically significant(P<0. 05).4. Quality of lifeAfter the operation, all the patients were followed up. During the follow-up period, no recurrence or death cases. All patients began to regain sexual life in postoperative 3 ~ 6 months. In this study, the female sexual function scale(see Appendix) was used to evaluate the sexual function of two groups of patients after 12 months of operation.The study group was significantly better than the control group(P < 0.05) in the aspects of sexual satisfaction, sexual pain and orgasm, There was no significant difference between the two groups(P>0.05) in sexual lubrication, sexual desire and sexual arousal.Conclusions: The modified pelvic peritoneal suture is simple, it can effectively prolong the postoperative vaginal length, and improve postoperative quality of life. It is worthy of promotion.