ABSTRACT
Objective@#To introduce the laparoscopic type C1 hysterectomy based on the anatomic landmark of the uterus deep vein and its branched and to evaluate its feasibility and safety for cervical cancer and its effect to bladder function and to provide some reference to simplify the surgical procedures of laparoscopic type C1 hysterectomy.@*Methods@#The clinicopathologic data of the patients with stage ⅠA2~ⅡB cervical cancer and who underwent the laparoscopic C1 hysterectomy based on anatomic landmark of the uterus deep vein and its branches between March 2010 and December 2015 was retrospectively analysed.@*Results@#A total of 99 patients received laparoscopic type C1 hysterectomy based on the anatomic landmark of the uterus deep vein and its branches, in which 93 patients reserved unilateral or bilateral pelvic autonomic nerve successfully, the other 6 patients were transfered to receive type C2 hysterectomy due to adhesions, bleeding or the low possibility of curative resection. The failure rate of the surgery was 6.1% (6/99). The average age of these 93 patients was 44.4±8.2 years (range 25~61 years) and there was one case of stage ⅠA2, 84 stage ⅠB1, 2 stage ⅠB2, 5 stage ⅡA1 and 1 stage ⅡB. The number of patients with squamous cell carcinoma was 67, adenocarcinoma was 19, adenosquamous carcinoma was 3, small cell neuroendocrine carcinoma was 3 and mixed type was 1. The average operation time was 4.1±0.5 h, the average amount of intraoperative blood loss was 103.8±84.0 ml and the mean number of excisional pelvic lymph nodes was 29.7±8.9. There was no patient with positive parametrial margin, positive vaginal margin or intraoperative ureteral injury. The postoperative catheter extraction time was 20.3±8.4 d. The median follow-up time was 20 months (rang 5~44 months), the long-term bladder dysfunction rate was 8.6% (8/93). The numbers of locally uncontrolled and distantly metastasis case were both one and both patients died. The fatality rate were 2.2% (2/93). The two-year disease-free survival and overall survival rate were 97.6% and 96.2%, respectively.@*Conclusion@#Laparoscopic type C1 hysterectomy based on the anatomic landmark of the uterus deep vein and its branches is a safe and feasible treatment method for cervical cancer and it provides a new approach for simplifying the surgical procedures of laparoscopic type C1 hysterectomy.
ABSTRACT
Objective To analyze the incidence of hospitalized children with Henoch-Sch(o)nle in purpura (HSP) and Henoch-Sch(o)nlein purpura nephritis (HSPN) from 2009 to 2012,and to characterize the epidemiology of HSP and HSPN in Jiangxi province.Methods Inpatients of Jiangxi Children's Hospital with the diagnosis of HSP or HSPN were recruited during 2009 to 2012.The basic messages in the home page of medical records,such as the admission year,sex,age,area coming from were collected.Chi-square test was used for statistical analysis.Results A total of 2516 HSP pediatric patients were included in this study.Of whom,412 cases were diagnosed in 2009,568 cases in 2010,750 cases in 2011,786 cases in 2012.Among them,renal damage as the presenting symptom in 110 cases in 2009,148 cases in 2010,198 cases in 2011,and 196 cases in 2012.The average incidence of HSPN was 25.91％ (652/2516).The morbidity of HSPN were similar in different admission years (x2=0.62,P＞0.05).In HSP patients,the ratio between male and female was 1.59∶1; the peak age was 4 to 9 year-old (65.50％,1648/2516).The morbidity of HSPN was similar in both girls and boy patients group (x2=0.14,P＞0.05).The morbidity of HSPN was 18.76％ (163/869) in patients younger than 6 years old,which was lower than 26.85％(359/1337) in patients between age 6 to 11 years old,and the morbidity of HSPN was 41.94％ (130/310) in patients older than 11years old,the difference was significant (x2=65.24,P＜0.01).The morbidity of HSP in the month of year was different,the peak time was between October and December,which as 40.74％(1025/2516).The morbidity of HSPN was 30.23％(208/688) during January to March,higher than in other period of the year (x2=9.87,P＜0.05).In the last four years,there were 824(32.75％) hospitalized patients of HSP in Nanchang district,1692 cases (67.25％) in other areas in Jiangxi province.The morbidity of HSPN in Nanchang district was 17.35％ (143/824),compared with the average level 25.91％(652/2516),the difference was significant (x2=25.08,P＜0.01).Conclusion The number of children diagnosed with HSP is progressively increased from 2009 to 2012 in Jiangxi province.The peak period for HSP is between October and December,and the peak age is 4 to 9 year-old.The incidence of HSPN between January to March group is higher than in other periodof the year.The morbidity of HSPN is increased with age.