保留神经的根治性子宫切除术在区域癌症中心的应用效果评价

Yu. A. Kolotilov, E. A. Kruglov, A. N. Kazantsev, V. M. Unguryan
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引用次数: 0

摘要

研究的目的。评价本中心采用神经切除根治性子宫切除术的近期和远期效果,即并发症的发生频率、手术时间、出血量、泌尿生殖系统疾病,并将所获得的数据与世界文献有关这一问题的数据进行比较。患者和方法。2019年8月至2022年10月,55例确诊为宫颈癌并行保神经根治性子宫切除III/C1型的患者在区域临床肿瘤药房接受治疗。年龄范围31 ~ 69岁,平均年龄47.3岁。分析术后指标:手术时间、出血量、残尿量、术后住院时间、并发症、死亡率、淋巴结检查数。对随访时间超过12个月(42-12个月)的患者进行长期肿瘤结果分析,估计复发频率、进展频率和进展死亡率。结果。术后平均手术时间为286分钟;出血量216.1 ml,第5天残尿量52.4 ml,术后住院时间11.1 d, II级并发症按Clavien - Dindo - 3.6%, III级并发症按Clavien - Dindo - 3.6%,术后无死亡,检查淋巴结数18.3个。随访期间,复发率为0%,无复发生存率为91%,进展和进展死亡率分别为7%和3.5%(4例和2例)。通过将该方法与关于类似问题的世界文献中提供的数据进行比较,评价了该方法执行的有效性。同时发现手术时间、出血量、并发症及泌尿生殖系统疾病发生频率、复发及进展频率与国际文献数据无明显差异。结论。在地区肿瘤医院,在宫颈癌手术中引入保留神经的III/C1型子宫切除术技术是相对安全、平易近人的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of nerve‑sparing radical hysterectomy introduction efficiency in the regional cancer center
The purpose of the study. To evaluate the immediate and long–term results of the introduction of nerve‑s paring radical hysterectomy into the practice of the center, namely, the frequency of complications, duration of surgery, blood loss, genitourinary disorders and compare the data obtained with the data of the world literature on this issue. Patients and methods. In the period from August 2019 to October 2022, 55 patients diagnosed with cervical carcinoma who underwent nerve‑ sparing radical hysterectomy type III/C1 were treated in the conditions of the regional clinical oncological dispensary. The age category ranged from 31 to 69 years, the average age was 47.3 years. The following postoperative indicators were analyzed: duration of surgery, blood loss, amount of residual urine, duration of hospital stay after surgery, complications, mortality, number of lymph nodes examined. The analysis of long‑term oncological results in patients with a follow‑up period of more than 12 months (42–12 months) was carried out, the frequency of relapses, the frequency of progression, and mortality from progression were estimated. Results. The obtained postoperative averages, such as: the duration of the operation, amounted to 286 minutes; blood loss – 216.1 ml, the volume of residual urine on the 5th day 52.4 ml, the duration of hospital stay after surgery 11.1 days, complications of the II degree according to Clavien–Dindo – 3.6 %, complications of the III degree according to Clavien‑ Dindo – 3.6 %, there was no postoperative mortality, the number of lymph nodes examined was 18.3. During the follow‑up period, the recurrence rate was 0 %, relapse‑free survival was 91 %, progression and mortality from progression were 7 % and 3.5 (4 and 2 patients), respectively. The effectiveness of the implementation of the methodology was evaluated by comparing it with the data given in the world literature on a similar issue. At the same time, it was found that the duration of the operation, blood loss, the frequency of complications and genitourinary disorders, the frequency of relapse and progression did not differ significantly from the data of the international literature. Conclusion. The introduction of the technology of nerve‑ sparing hysterectomy of the uterus type III/C1, in cervical cancer surgery is relatively safe and approachable in a regional oncology hospital.
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