The Clinical Application Value of Modified Laparoscopic Radical Surgery with-out Uterine Manipulator in Early Cervical Cancer / 实用妇产科杂志

ABSTRACT

Objective:To explore the clinical value of modified laparoscopic radical surgery without uterine ma-nipulator in the treatment of early cervical cancer.Methods:A retrospective analysis was conducted on the clinical data of 105 patients with early cervical cancer(stages ⅠB1,ⅠB2,ⅡA1)who underwent radical resection of cer-vical cancer in West China Second University Hospital,Sichuan University from January 2019 to January 2020.According to the operation methods,the patients were divided into uterine lifter-free group(35 cases),uterine lifter group(35 cases)and laparotomy group(35 cases).The operation duration,intraoperative blood loss,number of resected lymph nodes,postoperative anal exhaust time,drainage tube placement time,hospitalization time,inci-dence of surgical complications,recurrence rate and mortality rate were compared among the three groups.Re-sults:There was no statistically significant difference in the number of lymph node resection,the postoperative anal exhaust time,drainage tube placement time and hospitalization time among the three groups(P>0.05).Comparison between two groups showed that the operation time of the group without uterine lifting was longer than that of the laparotomy group,and the intraoperative bleeding volume and the Postoperative anal exhaust time of the laparotomy group were more than those of the other two groups,and the differences were statistically signif-icant(P<0.05).There were 18 cases of surgical complications in the three groups.The incidence rate of uterine lifter-free group,laparotomy group and uterine lifter group was 11.4%,20.0%and 20.0%,respectively,with no statistically significant difference(P>0.05).There were 8 patients with recurrence 2 years after operation,the re-currence rates of the uterine lifter-free group,the laparotomy group and the uterine lifter group were 0,5.7%and 17.1%,respectively,the difference was statistically significant(P<0.05).The recurrence rate of the group with-out uterine lifting was significantly lower than that of the uterine lifting group(P<0.05).There were0 death in the non-lifting group,0 in the laparotomy group,and 1 case in the uterine lifting device group within 2 years after oper-ation,the difference was no statistically significant(P>0.05).Conclusions:The modified laparoscopic radical re-section without uterine lifter can reduce the risk of tumor recurrence in laparoscopic radical resection with uterine lifter,which is equivalent to the treatment effect of open surgery,and does not increase the risk of surgical compli-cations.It has clinical application value.