目的:宫颈癌根治术的并发症会增加患者的痛苦,影响患者的生活质量。这项回顾性研究通过观察宫颈癌患者的并发症,评估了根治性子宫切除术(RH)伴盆腔淋巴结清扫术(PLND)的安全性。我们的发现可能为预防和减少并发症提供经验和证据。
方法:共纳入2226例符合纳入标准的宫颈癌患者。所有患者均行RH+PLND。记录术中对邻近组织的损伤及近期、远期并发症,分析与并发症发生相关的因素。
结果:34.41%(766/2226)的患者发生术后并发症,包括7.68%的邻近组织损伤患者,31.45%伴有短期并发症,2.96%伴有长期并发症。年龄,肿瘤大小,侵入深度,宫旁入侵,淋巴管间隙侵犯(LVSI),淋巴结转移,国际妇产科联合会(FIGO)阶段,手术方式与RH+PLND术后并发症密切相关(P<0.05)。
结论:本研究结果表明RH+PLND治疗宫颈癌是安全可行的。40-60岁的患者,肿瘤≥4厘米,侵入深度≥2/3,宫旁侵入,LVSI,淋巴结转移,FIGO分期>IB2,并且接受开放手术的患者更容易发生并发症。
OBJECTIVE: The complications of radical surgery for cervical cancer can increase patient suffering and affect their quality of life. This retrospective
study assessed the safety of radical hysterectomy (RH) with pelvic lymph node dissection (PLND) by observing the complications of patients with cervical cancer who underwent this procedure in a single centre over 10 years. Our findings may provide experience and evidence for preventing and reducing complications.
METHODS: A total of 2226 cervical cancer patients who met the inclusion criteria were enrolled. All patients underwent RH + PLND. Intraoperative injury to adjacent tissues and short-term and long-term complications were recorded to analyze factors associated with the occurrence of complications.
RESULTS: Postoperative complications occurred in 34.41% (766/2226) of patients, including 7.68% of patients with injury to adjacent tissues, 31.45% with short-term complications, and 2.96% with long-term complications. Age, tumor size, invasion depth, parametrial invasion, lymph vascular space invasion (LVSI), lymph node metastasis, International Federation of Gynaecology and Obstetrics (FIGO) stage, and surgical procedure were closely associated with the postoperative complications of RH + PLND (P < 0.05).
CONCLUSIONS: The results of this
study showed that RH + PLND for cervical cancer is safe and practical. Patients aged 40-60 years, with tumors ≥ 4 cm, invasion depth ≥ 2/3, parametrial invasion, LVSI, lymph node metastasis, FIGO stage > IB2, and who underwent open surgery were more prone to complications.