What are the complications after cervical cancer surgery? What are the treatments for cervical cancer?

How to choose the treatment of cervical cancer? The mortality rate of cervical cancer in my country is getting higher and higher. Because its early symptoms are not obvious, it is easy to be ignored. When it is discovered, it is often in the middle and late stages. Due to the difficulty in treatment, many patients and their families are very concerned about the treatment of cervical cancer. How to choose the treatment of cervical cancer?

How to choose the treatment for cervical cancer?

1. Treatment principles

1. Atypical hyperplasia: If the biopsy is mild atypical hyperplasia, it is temporarily treated as inflammation, and the scraping is followed up for half a year, and biopsy is performed if necessary. Those whose lesions remain unchanged can continue to be observed. The diagnosis of moderate atypical hyperplasia should be applicable to laser, freezing and electric ironing. For severe atypical hyperplasia, total hysterectomy is generally advocated. If fertility is urgently needed, regular close follow-up can also be performed after cone resection.

2. Carcinoma in situ: It is generally recommended to perform a total hysterectomy and retain both ovaries; it is also recommended to remove 1~2cm of the vagina at the same time. Laser treatment has been useful in recent years at home and abroad, but close follow-up is required after treatment.

3. Microscopic early invasive cancer: generally, extended total hysterectomy and 1-2 cm vaginal tissue are recommended. Pelvic lymphatic tissue does not need to be eliminated because the possibility of lymphatic metastasis of microscopic early invasive cancer is very small.

4. Invasive cancer: Treatment is based on clinical stage, age, physical condition and equipment conditions. Common treatment methods include radiotherapy, surgery and chemotherapy. Generally speaking, radiotherapy is suitable for patients at all stages; the efficacy of surgery for stage Ib to IIa is similar to that of radiotherapy; cervical adenocarcinoma is slightly less sensitive to radiotherapy and should be treated with a combination of surgical resection and radiotherapy.

2. Surgical treatment

Wide hysterectomy and pelvic lymph node removal are used. The removal range includes the entire uterus, bilateral adnexa, upper vagina and paravaginal tissues, and pelvic lymph nodes (paracervical, obturator, internal iliac, external iliac, and lower common iliac lymph nodes). The operation needs to be thorough, safe, with strict indications and prevention of complications.

3. Complications and surgical treatment

1. Complications such as intraoperative bleeding, postoperative pelvic infection, lymphocele, retention, urinary tract infection, ureterovaginal fistula, etc.

2. In recent years, the incidence of the above complications has been significantly reduced due to improvements in surgical methods and anesthesia techniques, the use of preventive antibiotics, and the adoption of postoperative extraperitoneal negative pressure drainage.

4. Radiation therapy

The first-line treatment for cervical cancer can be applied to all stages of cervical cancer, including the cervix and affected vagina, uterine body, parauterine tissue and pelvic lymph nodes. The irradiation method generally adopts a combination of internal and external irradiation. Internal irradiation is mainly aimed at the primary adjacent parts of the cervix, including the uterine body, upper vagina and its adjacent parauterine tissue ("A") point. External irradiation is mainly aimed at the pelvic lymph node distribution area ("B") point. The internal radiation source uses intracavitary laser (Ra) or 137 cesium (137Cs), which is mainly aimed at the primary lesions of the cervix. The external radiation source is 60 cobalt (60 cobalt) Co), which is mainly used for metastatic lesions outside the primary lesion, including the pelvic lymph node drainage area. The dose is generally 60Gy. At present, early cervical cancer mainly advocates internal irradiation first. For advanced cancer, especially those with huge local tumors, active bleeding, or accompanied by infection, external irradiation should be used first.

5. Chemotherapy

So far, cervical cancer is not sensitive to most anticancer drugs, and the effective rate of chemotherapy does not exceed 15%. Advanced patients can be treated with comprehensive treatments such as chemotherapy and radiotherapy. Chemotherapy drugs can be intravenously or locally injected with 5-fluorouracil and doxorubicin.