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目的探讨卵巢癌患者保留生育功能的手术治疗的可行性。方法收集2004-2009年四川省自贡市第四人民医院收治的卵巢癌分期为I期的上皮性卵巢癌患者,根据是否保留生育功能分为A、B两组,排除不保留生育功能的B组中年龄>55岁的病例,其中A组29例,B组41例。A组的手术方法为:单侧附件切除,单/双侧卵巢肿物剥除,单/双侧卵巢肿物剥除同时行分期手术(盆腔淋巴结清扫、大网膜切除、阑尾切除,必要时行对侧卵巢及腹膜活检);B组的手术方法为:全子宫双附件切除+盆腔淋巴结清扫+大网膜切除+阑尾切除。比较两组病例的肿瘤分期、病理分型、存活率、复发情况,以及保留生育功能病例的月经及妊娠情况。结果排除部分病例后,A、B两组的年龄,肿瘤分期差异无统计学意义(P>0.05),两组病例生存率差异无统计学意义(P>0.05)。29例保留生育功能的患者均在术后有月经回潮,其中21例在1年内月经恢复正常,8例无周期规律性月经,并有5例孕育成功。结论对于有保留生育功能期望的Ⅰ期上皮性卵巢癌的年轻患者,保留生育功能的手术是安全合适的选择。
Objective To investigate the feasibility of surgical treatment of ovarian cancer patients with reproductive function. Methods The patients with epithelial ovarian cancer who had stage I ovarian cancer who were admitted to the Fourth People’s Hospital of Zigong City in Sichuan Province from 2004 to 2009 were divided into two groups according to whether their reproductive functions were retained or not, Middle age> 55 years old cases, including 29 cases in group A, 41 cases in group B. A group of surgical methods are: unilateral annex removal, single / bilateral ovarian tumor removal, single / bilateral ovarian tumor stripping at the same time staging (pelvic lymph node dissection, omental resection, appendectomy, if necessary Opposite ovary and peritoneal biopsy); B group of surgical methods: whole hysterectomy double attachment + pelvic lymph node dissection + omentum resection + appendectomy. Tumor stage, pathological type, survival rate and recurrence were compared between the two groups, and the menstrual and pregnancy status of cases with reproductive function were retained. Results Excluding some cases, there was no significant difference in age and tumor stage between A and B groups (P> 0.05). There was no significant difference in survival rate between the two groups (P> 0.05). Twenty-nine of 29 patients with reproductive function retained menstrual resurgence after operation. Among them, 21 patients returned to normal within one year, 8 had no regular menstrual cycle, and 5 had successful pregnancy. Conclusions For young patients with stage I epithelial ovarian cancer that have retained fertility expectations, surgery to preserve fertility is a safe and appropriate option.