[早期宫颈癌腹腔镜根治性气管切除术的肿瘤学效果]。

Q Liu, Y X Sun, K J Liu, P Q Li, X X Zhao, Z J Hu
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引用次数: 0

摘要

目的分析并总结早期宫颈癌腹腔镜根治性气管切除术(LRT)的肿瘤治疗效果。方法:对 148 例早期宫颈癌患者的临床数据和随访结果进行分析:收集2014年7月-2023年6月在上海交通大学医学院附属仁济医院接受LRT治疗的148例早期宫颈癌患者的临床资料和随访结果,并对肿瘤预后和术后妊娠情况进行回顾性分析。结果:(1)一般情况:148 例 LRT 患者的中位年龄为 33 岁(范围:19-42 岁)。病理类型:鳞状细胞癌 111 例,腺癌 36 例,腺鳞癌 1 例。国际妇产科联盟(2018)分期:Ⅰa1期伴淋巴管间隙侵犯17例,Ⅰa2期25例,Ⅰb1期102例,Ⅰb2期4例。 (2)肿瘤结局:148 例患者在 LRT 后接受了定期随访,中位随访时间为 59 个月(范围:2-104 个月)。随访期间,5 例肿瘤复发(包括 1 例死亡),中位复发时间为 10 个月(范围:4-33 个月)。其中,盆腔转移 3 例,远处转移 1 例,盆腔和远处均转移 1 例。148例患者的3年和5年无病生存率均为94.5%,5年总生存率为98.9%。(3)术后妊娠:在148例LRT患者中,67例患者有妊娠要求,随访1年,其中20例妊娠,妊娠率为29.9%(20/67)。20 例妊娠患者中,早期流产 2 例,中期流产 1 例,分娩 17 例(其中早产 4 例,足月分娩 13 例)。结论在严格控制手术指征、保证手术范围和无肿瘤的情况下,早期宫颈癌患者的 LRT 治疗效果良好。
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[Oncological outcomes of laparoscopic radical trachelectomy for early stage cervical cancer].

Objective: To analyze and summarize the oncological outcomes after laparoscopic radical trachelectomy (LRT) for early stage cervical cancer. Methods: The clinical data and follow-up results of 148 patients with early stage cervical cancer who underwent LRT in Renji Hospital, School of Medicine, Shanghai Jiao Tong University from July 2014 to June 2023 were collected, while tumor outcomes and postoperative pregnancy were analyzed retrospectively. Results: (1) General situation: the median age of 148 patients with LRT was 33 years (range: 19-42 years). Pathological type: 111 cases of squamous cell carcinoma, 36 cases of adenocarcinoma, 1 case of adenosquamous carcinoma. International Federation of Gynecology and Obstetrics (2018) stage: 17 cases of stage Ⅰa1 with lympho-vascular space invasion, 25 cases of stage Ⅰa2, 102 cases of stage Ⅰb1, and 4 cases of stage Ⅰb2. (2) Tumor outcomes: 148 patients were followed up regularly after LRT, and the median follow-up time was 59 months (range: 2-104 months). During the follow-up period, 5 cases of tumor recurred (including 1 death), and the median recurrence time was 10 months (range: 4-33 months). Among them, there were 3 cases of pelvic metastasis, 1 case of distant metastasis, and 1 case of both pelvic and distant metastasis. Both 3-year and 5-year disease-free survival rates of 148 patients were 94.5%, and the 5-year overall survival rate was 98.9%. (3) Postoperative pregnancy: among 148 patients with LRT, 67 patients had pregnancy requirements, followed up for 1 year, and 20 of them were pregnant, with a pregnancy rate of 29.9% (20/67). Among the 20 pregnant patients, 2 cases early abortion, 1 case mid-term abortion, and 17 cases gave birth (including 4 cases of premature birth and 13 cases of full-term birth). Conclusion: Under the condition of strict control of surgical indications, guaranteed surgical scope and tumor-free operation, LRT in patients with early cervical cancer has a good outcome.

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[Analysis of perinatal outcomes in pregnant women with the resolution of placenta previa in the second trimester]. [Clinical effect of secondary LEEP combined with transcervical resection of endocervical tissue for cervical precancerous lesions with positive internal margin after the first LEEP]. [Diagnostic value of prenatal ultrasound screening and analysis of pregnancy outcomes in velamentous umbilical cord insertion]. [Expanded carrier screening for 216 diseases in a cohort of 3 097 healthy Chinese individuals of childbearing age]. [Expert consensus on diagnosis and treatment of chronic pelvic pain].
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