【摘要】 目的 探讨扩大性宫颈切除术保守性治疗早期宫颈癌(0～Ⅰa1期)的可行性和安全性。方法 于2002年3月～2005年3月，选择宫颈鳞状上皮原位癌(阴道镜下病变面积≥3/4或宫颈活检提示早浸可疑)、宫颈鳞癌Ⅰa1期(脉管内未见癌栓)、年龄≤40岁的病例，患者要求保留子宫及生育能力，自愿要求此术式，并告知患者及家属此手术并非是早期宫颈癌的标准治疗方式。结果 22例早期宫颈癌患者接受此术式手术治疗，其中0期12例，Ⅰa1期10例，中位年龄32岁(23～39岁)；平均手术时间：41min(37～68min)；平均出血量：89.6ml(30～220ml)；平均住院天数：11天(9～12天)。无手术并发症；中位随访时间21.6个月，无一例复发，月经及性生活正常；其中2例受孕，分别于孕45、64天行人工流产术。结论 严格掌握病例选择，扩大性宫颈切除术是一种治疗0～Ⅰa期宫颈癌有效、安全的术式。

    【关键词】 扩大性宫颈切除术；早期宫颈癌

    Cervical enlarged resection-a surgical technique for early stage cervical carcinoma

    ZENG Si-yuan,LI Long-yu,LI Han-ping,et al.

    Department of Gynecologic Oncology,Maternal and Child Health Hospital of Jiangxi Province,Nanchang 330006,China

    【Abstract】 Objective To evaluate the feasibility and security of treatment in early stage cervical carcinoma(stage 0-Ⅰa1)with cervical enlarged resection.Methods From march 2002 to march 2005,patients(≤40 years) with cervical carcinoma in situ(the area of lesions≥3/4 on coloposcopic examination or doubt invasive carcinoma) and stage Ⅰa1(capillary vascular space involvement )who wanted to preserve fertility and corpus uteri were selected.All patients were informed that this therapy did not represent stand treatment for early stage cervical carcinoma.Results 22 cases of early stage cervical carcinoma,12 with stage 0 and 10 with stage Ⅰa1,were performed the procedure successfully.The median operation time was 41 minutes(range 37-68 minutes),median blood loss 89.6ml (range 30～220ml),and median hospital stay 11 days(range 9～12days).All patients had no significant intraoperative or postoperative complications.The current median follow-up time was 21.6 months and none of them had recurrence.After operation,all patients returned to normal menstrual function and sexual life.Among them 2 cases with pregnancy had abortion at 45 and 64 days respectively.Conclusion Cervical enlarged resection appears to be a secure and feasible procedure in well-selected patients with early stage cervical carcinoma. ......