摘要
目的探讨早期子宫内膜癌腹腔镜手术的有效性和安全性。方法回顾性分析我院2003年8月～2010年10月79例早期子宫内膜癌分别施行腹腔镜手术(腹腔镜组,n=56)和开腹手术(开腹组,n=23)的临床资料,比较2组手术时间、术中出血量、淋巴结切除数量、术后排气时间、并发症、术后住院时间、术后病率和复发率。结果腹腔镜组术中出血量(157.1±111.2)ml明显少于开腹组(221.7±169.8)ml(t=1.349,P=0.049)。与开腹组比较,腹腔镜组术后肛门排气时间和住院时间明显缩短(t=4.055,P=0.000;t=2.310,P=0.028)。2组手术时间、盆腔淋巴结切除数目、术后并发症、术后病率均无统计学差异(P>0.05)。术后随访至2011年2月,腹腔镜组50例随访4～82个月,平均28.7月,1例24个月复发,1例31个月穿刺部位转移,无死亡病例;开腹组20例随访17～64个月,平均39.0月,1例27个月复发,1例59个月死亡,2组复发率无统计学差异(精确概率法,P=0.493)。结论早期子宫内膜癌腹腔镜手术较开腹手术具有出血少、恢复快等优势,可作为子宫内膜癌手术的又一选择,远期疗效仍有待探索和证实。
Objective To evaluate the feasibility and safety of laparoscopy for endometrial carcinoma in an early stage.Methods From August 2003 to October 2010,79 patients with early-stage endometrial carcinoma who underwent laparoscopic（LPS group,n=56） or laparotomic（LPT group,n=23） surgeries were retrospectively analyzed.The operation time,intraoperative blood loss,number of resected pelvic lymph nodes,gastrointestinal recovery time,and postoperative complications,hospital stay,morbidity and recurrence rate were recorded and compared between the two groups. Results LPS group showed significantly less intraoperative blood loss,and shorter gastrointestinal recovery time and hospital stay [（157.1±111.2） ml vs.（221.7±169.8） ml,t=1.349,P=0.049;t=4.055,P=0.000;and t=2.310,P=0.028,respectively].No significant difference was found in the number of resected pelvic lymph nodes,postoperative complications and morbidity（P0.05）.The patients were followed up until February 2011.The mean follow-up in the LPS group（50 cases） was 28.7 months（ranged from 4 to 82 months）,and that in the LPT group was 39.0 months（ranged from 17 to 64 months）.In the LPS group,1 patient showed recurrence in 24 months,and 1 patient developed metastasis at the puncture site at month 31,but no patient died.In the LPT group,1 patient showed recurrence in 27 months,and 1 patient died at month 59.No significant difference was found in the recurrent rate between the two groups（P=0.493）.Conclusions Compared with open surery,laparoscopic surgery has the advantages of less blood and quick recovery in the treatment of early-stage endometrial carcinoma.It may be another choice for endometrial carcinoma,but its clinical value needs to be confirmed by long-term research.
出处
《中国微创外科杂志》
CSCD
2011年第5期411-414,共4页
Chinese Journal of Minimally Invasive Surgery
关键词
子宫内膜癌
腹腔镜手术
开腹手术
Endometrial cancer
Laparoscopic surgery
Laparotomy
