目的:探讨改良腹膜外淋巴结清扫术及阴式广泛性子宫切除术在浸润型宫颈癌治疗中的应用价值。方法:2004年10月至2006年10月,我们对18例ⅠA2期至ⅡA期的宫颈癌患者实施了经腹的腹膜外淋巴结清扫术及经阴道广泛子宫切除术。腹部淋巴结清扫的单侧切口长约5 cm。在经阴道的广泛子宫切除术时,无需行Schuchardt切口,而是首先切除宫骶韧带,再游离输尿管。结果:18例手术均获成功,平均手术时间212±20.32分钟,平均出血量530±35.12ml,平均术后肛门排气时间26±4.15小时,平均清扫盆腔淋巴结数目31±2.23个。术后无尿潴留发生。结论:改良腹膜外盆腔淋巴结清扫术及经阴道广泛子宫切除术安全可行;并可先于输尿管游离之前,切除宫骶韧带,有利于充分暴露术野,有利于打开输尿管隧道。 Objective: To explore the value of modified extraperitoneal lymph node dissection and vaginal extensive hysterectomy in the treatment of invasive cervical cancer. METHODS: From October 2004 to October 2006, we performed transabdominal extraperitoneal lymphadenectomy and extensive vaginal hysterectomy in 18 patients with stage IA2 to stage IIA cervical cancer. Abdominal lymph node dissection unilateral incision length of about 5 cm. In a transvaginal extensive hysterectomy, the Schuchardt incision is not required, but the uterosacral ligaments are removed first and then the ureter is released. Results: All the 18 surgeries were successful. The average operation time was 212 ± 20.32 minutes and the average amount of bleeding was 530 ± 35.12ml. The average postoperative anal exhaust time was 26 ± 4.15 hours. The mean number of pelvic lymph nodes was 31 ± 2.23. No postoperative urinary retention occurred. Conclusion: It is safe and feasible to improve extraperitoneal pelvic lymph node dissection and transvaginal extensive hysterectomy. Uterosacral ligaments can be removed before the ureter is free, which is good for exposing the operative field and opening the ureteral tunnel.