| Objective:To investigate the effect of laparoscopic radical resection of cervical cancer with ovarian preservation and displacement on the prognosis and quality of life of patients with cervical cancer.Methods:From January 2014 to December 2016,358 patients with cervical cancer underwent laparoscopic surgery in the first affiliated hospital of Bengbu medical college were selected,and divided into the observation group and the control group.Observation group:83 cases of cervical cancer which Bilateral or unilateral ovaries were retained;Control group:275 cases,pure laparoscopic radical resection of cervical cancer(extensive hysterectomy + double accessory resection + pelvic lymph node dissection).Six months after operation,two groups of patients were investigated by questionnaire and evaluated by modified kupperman score to observe the severity of perimenopausal syndrome;With reference to the preoperative menstrual cycle,sex hormones such as ovarian follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2)were measured 3 months and 6 months after operation in the two groups,and the changes of ovarian function were compared;The intraoperative blood loss and operation time were compared between the two groups,to explore whether laparoscopic radical hysterectomy and ovarian transposition operation increased the operation time and intraoperative blood loss;The patients in the observation group were followed up after operation.tumor markers such as squamous cell carcinoma antigen(SCC),carcinoembryonic antigen(CEA),alpha fetoprotein(AFP),carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199)andpelvic ultrasound and magnetic resonance imaging were detected regularly.the complications of ovarian displacement in the observation group were analyzed.the risk and feasibility of ovarian displacement in laparoscopic radical hysterectomy were discussed.Results:1.The modified kupperman score in the observation group was significantly lower than that in the control group.Normal life returned to normal 6 months after operation.In the control group,perimenopausal syndrome occurred in different degrees 6 months after operation,and the quality of life decreased significantly.The total score of modified kupperman in the observation group was lower than that in the control group(10 ± 6.3 VS 25 ± 7.5),and the difference was statistically significant(P<0.01)2.The levels of FSH,LH and E2 in the observation group were within the normal range 3 months and 6 months after operation,and the levels of FSH and LH in the control group were significantly higher than those in the control group,E2 decreased significantly.The FSH of the observation group was lower than that of the control group(7.33± 2.23 VS 37.07±4.34 mIU/ml),LH was lower than that of the control group(8.35±2.24 VS 35.03±10.56 mIU/ml),E2 was higher than that of the control group(122.23 ± 6.03 VS 22.43 ±11.35pg/ml),the difference was statistically significant(p<0.01).The FSH of the observation group was lower than that of the control group(8.53± 5.43 VS 41.03± 10.02mIU/ml),LH was lower than that of the control group(11.55±9.21VS 54.57±8.23 mIU/ml)and E2 was higher than that of the control group(113.51 ±4.56 VS 20.24±7.03 pg/ml)6 months after operation,the difference was statistically significant(p<0.01).3.There was no significant difference in intraoperative blood loss between the observation group and the control group(197.8± 14.73 VS 201 ± 15.85ml)(p>0.05).There was no significant difference between the two groups(3.15 ±0.54 VS 3.21 ±0.37h)(p>0.05).4.Comparison of the recent complications between the observation group and the control group:1 case of lymphatic cyst with infection,1 case of ureterovaginal leakage,2 cases of vaginal stump infection after operation in the observation group,3 cases of lymphatic cyst with infection after operation in the control group,1 case of ureterovaginal leakage,1 case of rectovaginal leakage,4 cases of vaginal stump infection,the recent complications between the two groups were not statistically significant(x2 = 0.106,p>0.05).5.83 patients in the observation group,including 58 cases of highly differentiatedsquamous cell carcinoma,3 cases of ovarian cyst,1 case of ovarian abscess,1 case of ovarian failure,1 case of residual ovarian syndrome,1 case of pain in the displacement site;20 cases of moderately differentiated squamous cell carcinoma and 2 cases of ovarian cyst after operation;Poorly differentiated squamous cell carcinoma 15 cases,ovarian cyst 1 case,ovarian metastasis 1 case.There was no statistically significant difference in the complications between the two groups(x2 = 0.195,p>0.05).Conclusion:1.For patients with cervical squamous cell carcinoma who keep ovarian function,preservation of single/bilateral ovary during operation can reduce the occurrence of perimenopausal syndrome.2.Laparoscopic radical resection of cervical cancer and ovarian transposition do not increase operative time and intraoperative blood loss.3.Laparoscopic ovarian preservation and transposition can better protect ovarian function,and the probability of complications after ovarian transposition is low,the probability of ovarian metastasis is also very low,proving that ovarian preservation is safe during operation... |
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