| 摘要: |
| ［摘要］ 目的 探讨改良输尿管隧道打开方式在宫颈癌经腹广泛性全子宫切除术中的安全性及其对减少术后泌尿系并发症的临床价值。方法 回顾性分析2021年1月1日至2022年7月31日在中国科学技术大学附属第一医院（安徽省立医院）接受经腹广泛性全子宫切除术的102例宫颈癌患者的临床资料。根据术中输尿管隧道处理方式不同，分为传统术式组50例和改良术式组52例。比较两组患者手术时间、术中出血量、手术切缘及术后泌尿系并发症等围手术期相关指标。结果 两组患者均顺利完成手术。改良术式组手术时间短于传统术式组［157.00（141.75，175.00）min vs 174.00（155.25，197.50）min］，术中出血量少于传统术式组［200.00（200.00，300.00）mL vs 300.00（200.00，400.00）mL］，差异有统计学意义（P<0.05）。术后病理结果显示，两组患者阴道切缘及宫旁切缘均未见肿瘤累及，手术切除范围达R0。改良术式组术后泌尿系并发症发生率显著低于传统术式组（19.23% vs 40.00%；P=0.030）。结论 该改良输尿管隧道打开方式在宫颈癌经腹广泛性全子宫切除术中具有良好的安全性，可显著降低术中出血量，缩短手术时间，具有较高的临床推广价值。 |
| 关键词: 宫颈癌 广泛全子宫切除术 输尿管隧道 手术技术改良 输尿管损伤 |
| DOI：10.3969/j.issn.1674-3806.2026.08.06 |
| 分类号: |
| 基金项目:“科大新医学”联合基金资助项目（编号：YD9110002049）；安徽省自然科学基金面上项目（编号：2408085MH207） |
|
| Application and clinical value of a modified ureteric tunnel dissection technique in abdominal radical hysterectomy for cervical cancer |
|
Lu Xiaofei, Chen Yao, Xia Bairong
|
|
Department of Gynecologic Oncology Surgery, West Branch, the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital), Hefei 230031, China
|
| Abstract: |
| ［Abstract］ Objective To investigate the safety of a modified ureteric tunnel dissection technique in abdominal radical hysterectomy for cervical cancer, and its clinical value in reducing postoperative urinary tract complications. Methods A retrospective analysis was conducted on the clinical data of 102 patients with cervical cancer who underwent abdominal radical hysterectomy in the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital) between January 1, 2021, and July 31, 2022. The patients were divided into a conventional technique group(n=50) and a modified technique group(n=52) based on different methods used for ureteric tunnel dissection during surgery. The perioperative indicators were compared between the two groups, including operative duration, intraoperative blood loss, surgical margins, and postoperative urinary tract complications. Results Successful operations were performed on all patients in both groups. The operative duration in the modified technique group was shorter than that in the conventional technique group［157.00(141.75, 175.00)min vs 174.00(155.25, 197.50)min］, and the intraoperative blood loss in the modified technique group was less than that in the conventional technique group［200.00(200.00, 300.00)mL vs 300.00(200.00, 400.00)mL］, with statistically significant differences between the two groups(P<0.05). Postoperative pathology revealed no tumor involvement in either the vaginal margins or the parametrial margins in the two groups, indicating an R0 resection. The incidence of postoperative urinary tract complications in the modified technique group was lower than that in the conventional technique group(19.23% vs 40.00%; P=0.030). Conclusion The modified ureteric tunnel dissection technique demonstrates good safety in abdominal radical hysterectomy for cervical cancer. The technique can significantly reduce intraoperative blood loss and shorten operative duration, and has considerable value for clinical application. |
| Key words: cervical cancer radical hysterectomy ureteric tunnel surgical technique modification ureteric injury |
