Research And Investigation On Rectum And Sexual Function Of Patients After Nerve-sparingradical Hysterectomy And Urvival Analysis

Radical hysterectomy and pelvic lymph node resection is an effectivemethod in early cervical cancers’ treatment, and have a higher cumulative5-yearsurvival rate. Surviving cervical carcinoma patients look forward to a betterquality of life after treatment, and the rising survival rate has also madegynecologic oncologists at home and abroad continue to improvetreatment.However, the most effective routine cervical cancer radical resectionis too easy to injury pelvic autonomic nerve, which always cause postoperativebladder, rectum and sexual dysfunction. NSRH surgery in early cervical cancertreatment could protect the pelvic nerve,so it was widely used.We had evaluatedthe postoperative bladder function and the recent rectum function within thepatients with pelvic autonomic nerve reserved surgery in our hospital for thefirst time, drew a conclusion that pelvic autonomic nerve preservation radicalhysterectomy had the feasibility and safety, could be beneficial to the recoveryof postoperative function of the bladder and rectum.This study is divided intotwo part to explore the advantage and security of NSRH surgery:1, throughquestionnaires, telephone follow-up, follow-up letters form to investigate the postoperative rectum function,sexual function,urinary bladder function ofpatients accepted NSRH surgery;2, Patients’ survival analysis after NSRHsurgery. RESEARCH AND INVESTIGATION ON RECTUM ANDSEXUAL FUNCTION OF PATIENTS AFTERNERVE-SPARINGRADICAL HYSTERECTOMYObjective: Research and investigation on long-term rectum and sexualfunction with the same period after NSRH and RH surgery.Method:72patients with FIGO Ib1~Ⅱb stage and accepted NSRH surgery(C1type in Q-M surgery typing) in the affiliated cancer hospital of guangximedical university during the period from March2008to December2013, andthere is a complete follow-up data for this study group.72cases in the controlgroup were randomly selected to receive radical hysterectomy withoutrecurrence in patients with C2type in Q-M typing. Long-term rectum and sexualfunction after undergoing surgeries of patients from the two groups wereretrospectively analyzed.Results: Rectum function: The ratio of nerve-sparing radical hysterectomygroup (Group C1) with symptoms of constipation is22.22%, while that ofradical hysterectomy (Group C2) is48.00%, the difference was significant (P<0.05). No big differences (P＞0.05) with the two groups in terms of diarrhea,tenesmus, fecal incontinence, irregular bowel movements, exhaust incontinence.Sexual function: the rating after investigation is listed in table6, no significant satisfaction and pain.Conclusion: NSRH surgery can improve long-term rectal function to someextent, but it cannot improve sexual function obviously. SURVIVAL ANALYSIS ON NERVE-SPARINGRADICAL HYSTERECTOMYObjective: Discussion on efficacy of NSRH surgery for early cervicalcancer and impact on patient after recovery.Method: Retrospectively reviewed the84patients after NSRH whodiagnosed and underwent surgery in the affiliated cancer hospital of guangximedical university between March2008and Aguest2012.Result: There was no significant difference in the5years disease-freesurvival(98.6%vs．93.0％)．5years over survival(98.6%vs.90.8%, P＞0.633)． Univariate analysis showed that pathological type of mucinousadenocarcinoma, deep stromal invasion and lymph node metastasis leaded topoor prognoses (P<0.05).Multivariate analysis showed that only lymph nodemetastasis was independentrisk factor that influence the prognosis of cervicaladenocarcinoma（P=0.011）.Conclusion: Comparing to RH surgery, NSRH surgery for early cervicalcancer is better, safer and effective with improvements to different extent onquicker recovery, shorter hospital stay and long-term quality of life...