Surgical treatment of cervical cancer
Vaginal cancer Surgical treatment of choice vaginal carcinoma in situ, fluorouracil chemotherapy, laser treatment or intraluminal brachytherapy. For patien...
Conventional treatment of cervical cancer As a cervical cancer, once diagnosed correctly, it should develop the most appropriate treatment programs, which are generally dominated ea...
Early cervical cancer is the main method of treatment. Especially right conditions without radiotherapy is more applicable good effect. The majority of writers that, in accordance with lesions, extent and clinical stages in patients with systemic conditions and the choice of appropriate procedure, and to better effect in the same time to minimize trauma and surgery with postoperative complications, so neither blind nor unprincipled to expand the narrow scope of operation. Indications for surgery in principle, limited to a period of 0 ~ II, right next to cervical cancer significantly eroded, to the appropriate radiotherapy. Younger patients may consider ovarian reservations over the age of 65 elderly patients with physical infirmity or heart, liver, kidney and other organ diseases are not implemented <BR> surgery.
1. Surgical treatment of carcinoma in situ
The mode of operation and cut cone hysterectomy. Indeed, can be confined to a small number of cervical carcinoma in situ cervical, Cone cut high recurrence rate, hysterectomy may also relapse, but is better than cutting cone, in particular for other indications to the uterus. Some of cervical carcinoma in situ multiple growth, expanding even a hysterectomy surgery, we can not complete resection of these lesions, there is no need to implement. If the preoperative lesions found in the vagina of a wider range, may consider surgery and radiotherapy. Comparisons of treatment at hysterectomy, Cone cut only for individual cases need to retain their fertility. No matter what the treatment, patients should be long-term follow-up. In addition to surgical resection, could still be implemented, defense, chilled and laser therapy.
2. Early invasive cervical cancer surgery
Surgery of the views is not consistent. The past tendency of many writers widely hysterectomy and pelvic lymphadenectomy, the surgical complications and mortality increased after long-term clinical practice, rarely found pelvic lymph node metastasis. Ia at home and abroad 1,118 cases of cervical cancer statistics, lymph node metastasis rate of 0.8%, that the appropriate surgical narrow scope. Should the depth of its infiltration, the scope of lesions, vascular space and lymphatic invasion, cell differentiation and the patient's specific situation and take appropriate procedure. Creasman, advocates interstitial infiltration 3mm will simply following hysterectomy; Infiltration 3 ~ 5mm, tumor fusion, OK radical hysterectomy and pelvic lymph node dissection; When a vascular invasion, regardless of deep infiltration, are radical operation. Tianjin, invasive cancer that within 5mm in depth, young patients who require fertility, Cervical Conization do regular follow-up; In less than 5mm Baptist cancer, and carcinoma in situ of the vagina, uterus or expand to the whole of hysterectomy, with enough vaginal wall resection; In less than 5mm cancer Baptist, lymphatic a tumor thrombus, a hysterectomy or expanded with vaginal hysterectomy part of the fornix, and removal of pelvic lymph nodes. Beijing Union Medical College Hospital for treatment of early invasive carcinoma: ① suspicious infiltration, infiltration and began infiltrating <1mm, OK simple hysterectomy, and vaginal wall resection 0.5 to 1cm; ② depth of invasion to be 1.1 to 3 mm wide at the hysterectomy (free ureteral , in 2-3cm pregnancy, vaginal wall resection 2cm), no lymph node resection; ③ 3.1 ~ 5mm depth of invasion, such as lesions scattered, no vascular invasion, also to the wider hysterectomy, such as tumor fusion, a vascular tumor thrombus, poorly differentiated cells, OK, radical hysterectomy and pelvic lymph node resection or radiotherapy. Literature, surgical treatment of early invasive carcinoma five-year survival rate was 95 to 100%. As long as we can make the timely diagnosis and appropriate surgery, will achieve satisfactory results.
3. Invasive cervical cancer surgery
B Ⅰ, Ⅱ a period of cervical cancer, domestic and foreign firms have advocated extensive hysterectomy and removal of pelvic lymph nodes. Its scope includes: 1 iliac bottom, inside and outside iliac, obturator and inguinal lymph tissue deep; ② pregnancy and hysterectomy, the uterus sacral ligament, the main ligament, bladder and vaginal cervical ligament resection of adjacent tissues at least 3cm; ③ wall of the vagina. Under a dome or under 3cm from cancer; ④ bilateral Annex. Following a 40-year-old patients with early cervical cancer, ovarian preservation side.
Shandong Medical University Hospital since 1963, the Ib, II and part of a Phase II b stage cervical cancer patients, routine retroperitoneal and pelvic lymph node removal of the peritoneal extensive hysterectomy, the surgical field good exposure, operate more convenient, thorough, reduced postoperative complications.
Shanghai hospitals through the surgical treatment of cervical 1,417 cases of invasive carcinoma of information that surgery should be based on lesion size, with specific conditions and sooner or later the situation to decide, and surgical resection of the roughly divided into four categories: a general category of abdominal surgery that total hysterectomy, including removal Yin Road dome to a 2cm. Apply to carcinoma in situ lesions and micro-long Baptist; The second category refers to general surgery abdominal hysterectomy for cervical including adjacent tissues 2cm, not to pelvic lymph nodes removed. Apply to invisible to the naked eye cancer, but biopsy confirmed early invasive carcinoma; Three types of abdominal surgery generally hysterectomy, including adjacent tissue resection of cervical and vaginal fornix 2cm above 2 ~ 3cm, for removal of pelvic lymph applicable to I2 and I3 period period (both international stage Ib ); four types of abdominal surgery generally hysterectomy, including along the pelvic wall adjacent tissue resection of cervical and vaginal fornix 3cm above, must also be cleared of lymph node. Apply to I4 II and the early period, that the international stage Ib and II of a period.
Hubei Medical College to cervical cancer surgery generals way into fascia, hysterectomy, the uterus of the wide excision, wide excision of the uterus and pelvic lymph node resection selective, extensive hysterectomy and pelvic lymph node removal, extensive hysterectomy and some ureter and / or resection of the bladder and to expand radical mastectomy six. Its purpose is to ensure the complete operation and security, minimize complications. But in practice, it is very difficult so specific. As for the expansion of the radical resection with or pots, mainly adapted to the pelvic radiotherapy failures and recurrence of bladder or rectum were involved. But the effect is poor, the high morbidity and mortality, only a small number of units. Cervical cancer of the vagina radical surgery, removal of restrictions and conditions related to abdominal surgery to improve, more abdominal have to be. As various regions vigorously anti-cancer screenings, early cervical cancer cases each year relative increase in treatment opportunities increased. Especially in radiotherapy equipment in China is still not perfect and the lack of treatment conditions, surgery for the treatment of early cervical cancer is an important method.
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Cervical cancer treatment What?
Reproductive care of patients with cervical cancer
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