| ObjectiveCervical cancer is the most common gynecologic malignant tumor.In recent years,the probability of young women suffer from cervical cancer is increasing,which has been got more and more attention by clinician.Traditional way of cervical cancer treatments is radical hysterectomy and radical radiotherapy,both treatments make the patients lose fertility,affect sexual function and endocrine function,even seriously affect the survival quality of patients,especially for young women that it is hard to accepted.With the cervical cancer screening technology advances, more and more early cervical cancer patients been diagnosis.Tumor treatment principle is to extend the patients survival at the same time improve the quality of survival, to the young cervical cancer patients, it is particularly important to retain reproductive function. In recent years, there are more and more reports about early cervical cancer with fertility-sparing surgery all over the world.This kind of surgery greatly improve the patients quality of life and has become a new research hotspot.But the safety of the operation,indications and prognosis remains to be further clinical study.This paper collected 16 cases in the first affiliated hospital of Zhengzhou University make a diagnosis and give treatment of young women with ealy cervical cancer clinical date,combined with the research date at home and abroad in recent years,comprehensive analysis of the operation indications,mode selection and prognosis,etc,and evaluate the safety and effectiveness,in order to provide the basis for clinical work. Subjects and methodsThe research collected 16 patients data, diagnosised and treatmented at The First Affiliated Hospital of Zhengzhou University from March 2013 to June 2015.All the cases, preoperative chief doctor of our hospital department of gynecology to check the results, cervical biopsy pathologic results and pelvic magnetic resonance check clearly the clinical stages, in our hospital pathology results confirmed that diagnosed with cervical cancer stage IA1 into IB1(tumor diameter 2 cm or less).All patients with cervical cancer staging method in this paper, on the basis of the 2010 international federation of gynecology and obstetrics(FIGO) clinical stage cervical cancer.One case has lymph node metastasis the gave up sparing fertility.The 6 patients who underwent extensive extensive trachelectomy as the case group,and I collected 6 groups which the same pathological types,the same stage young women cervical cancer patients,and randomly selected 1 patient from each group as the control group.Regular review of all the patients in our hospital.The study for the retrospective study, the follow-up time was December 1, 2015, the perioperative data statistics in all cases, postoperative disease-free survival and maternal projects, such as the case group and control group in disease-free survival after surgery the Log-rank test(?=0.05),the results compared with the research data at home and abroad in recent years, comprehensive evaluate the safety of the operation, effectiveness, and matters needing attention. ResultsThe study analyzed the 16 cases of young women with early cervical cancer,average age 29±6 years old,the first sexual life of 20±4 ages,the pregnancy rate of 2±1 times,preoperative cervical high risk tyte HPV(human papilloma virus) type 16 check are all positive,two patients combined with HPV18 positive. One case of patients to retain reproductive function after the operation, routine pathological results back to the lymph nodes transfer carries out "cervical cancer radical", 9 patients were successfully reserve uterus with the fertility-sparing surgery.Three stage IA1 patients are medical examination found that undergone cervical cone cutting, good postoperative recovery, postoperative follow-up 14±14month, no tumor recurrence signs.Two example patients with cervical squamous cell carcinomas IB1 period for preoperative tumor diameter(2 cm) larger line of three times neoadjuvant chemotherapy is put into practice "laparoscopic pelvic lymphadenectomy plus extensive resection of the cervical", consolidate all postoperative chemotherapy four times, one case of patients with postoperative tumor recurrence in November, finally died from cancer that has spread to the widely.Four cervical cancer patients with direct "laparoscopic pelvic lymphadenectomy+extensive resection of the cervical" surgery, has an average follow-up time was 24 months postoperatively, review no tumor recurrence. Three patients of the fertility-sparing try to pregnant, all successful natural pregnancy, two cases of early pregnancy without apparent cause spontaneous abortion, one case of successful pregnancy to term and profile control deliver one boy.Operation of 16 cases were successfully, intraoperative without blood transfusion, without peripheral viscera injury.Case group compared with control group disease-free surial after t=0.9,p>0.05,there was no statistically significant difference. ConclusionIn the short term(19±16 months),the difference has no obvious statistical significance between the fetility-sparing surgery and radical operation for young women with early stage cervical cance. |
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