国际生殖健康/计划生育 ›› 2011, Vol. 30 ›› Issue (2): 138-141.

• 综述 • 上一篇    下一篇

保留神经的根治性子宫切除术

朱 滔, 高永良   

  1. 310022 杭州,浙江省肿瘤医院妇瘤科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2011-03-15 发布日期:2011-03-15
  • 通讯作者: 高永良

Nerve-sparing Radical Hysterectomy

ZHU Tao, GAO Yong-liang   

  1. Department of Gynecology Oncology, Zhejiang Cancer Hospital, Hangzhou 310022, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2011-03-15 Online:2011-03-15
  • Contact: GAO Yong-liang

摘要: 传统的根治性子宫切除术术后常引起一系列并发症,如膀胱功能障碍、肛门直肠功能紊乱和阴道功能障碍等。随着肿瘤外科的发展,在根治性子宫切除术中通过保留盆腔自主神经可显著减少术后并发症,改善患者术后生活质量。由于缺乏传统的根治性子宫切除术与保留盆腔神经根治性子宫切除术的疗效和并发症的临床随机对照研究,所以尚不能广泛推广。近年开展的大量手术实践有相关技术创新和随访数据。现就近年保留神经的根治性子宫切除术的适应证、手术步骤、手术技巧和并发症的进展进行综述,并阐述需要研究的问题。

关键词: 宫颈肿瘤, 子宫切除术, 内脏神经, 膀胱, 手术后并发症

Abstract: Classic radical hysterectomy could frequently cause bladder dysfunction,anorectal mobility disorders and sexual dissatisfaction. Following improvement of surgical oncology, the autonomic pelvic nerves have been preseved during the phase of radical hysterectom, which has the lowed long?鄄term postoperative complications and the improved quality of life. Although many operations and practice have been carried out during the last two decades, studies comparing the effectiveness and complications of classic radical hysterectomy with nerve?鄄sparing radical hysterectomy, designed with the randomized case control, were scanty, which affected its widespread use in clinic. With the published follow?鄄up data and technique innovation, we reviewed the selection criteria, operating procedures, technical details and complications of the nerve?鄄sparing radical hysterectomy in early?鄄stage cervical cancer, and raised some expectations for future research and practice.

Key words: Uterine cervical neoplasms, Hysterectomy, Splanchnic nerves, Urinary bladder, Postoperative complications