Ⅰ期子宫内膜癌患者腹腔镜手术后中长期随访比较研究  

Long-term Follow-up for Patients with Stage Ⅰ Endometrial Cancer after Laparoscopic Surgery

作　　者：刘海防[1] 陈旭[1] 刘彦[1] 金志军[1] 

机构地区：[1]上海第二军医大学附属长征医院妇产科,上海200003

出　　处：《中国微创外科杂志》2009年第4期299-301,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨腹腔镜手术治疗Ⅰ期子宫内膜癌患者的预后。方法回顾性分析1993年5月～2008年5月腹腔镜手术治疗31例Ⅰ期子宫内膜癌(腹腔镜组)的临床资料,并与同期开腹手术治疗的52例(开腹组)进行比较,比较2种手术方法患者术中长期随访结果。结果2组临床亚分期Ⅰa、Ⅰb、Ⅰc期患者半数生存时间分别为77、51、31个月。83例死亡4例,总生存率95.2%(79/83)。开腹组死亡3例,总生存率94.2%(49/52);腹腔镜组死亡1例,总生存率为96.8%(30/31),2组总生存率差异无显著性(Z=0.028,P=0.978)。腹腔镜组与开腹组Ⅰa期患者半数生存时间比较差异无显著性(80月vs63月,P=0.48),腹腔镜组病理G1级患者半数生存时间明显长于开腹组(77月vs51月,P=0.037),腹腔镜组与开腹组Ⅰb、Ⅰc期及G2、G3级患者半数生存时间无显著差别(49月vs48月,P=0.78;51月vs49月,P=0.635))。结论鉴于腹腔镜手术的微创伤性及对Ⅰ期子宫内膜癌患者的预后有益,腹腔镜手术应该作为Ⅰ期子宫内膜癌的常规治疗方法。Objective To compare the long-term prognosis of patients with stage Ⅰ endometrial cancer （EMC） after laparoscopic surgery or open laparotomy. Methods Totally 83 patients with stage Ⅰ EMC who underwent laparoscopic surgery or open laparotomy between 1993 and 2008 were enrolled in this study. The clinical data were analyzed retrospectively to compare the survival time during long-term follow-up between the two groups. Results The total survival rate was 95.2% （79/83） in the 83 cases. The median survival time was 77,51,and 31 months respectively in stages Ⅰa,Ⅰb,and Ⅰc EMC patients. No significant difference was found in the survival rate between open and laparoscopy groups [94.2% （49/52） vs 96.8% （30/31）,Z=0.028,P=0.978]. For the stage Ⅰa,stages Ⅰb and Ⅰc,and G2 and G3 patients,the median survival time was similar between the open and laparoscopy groups （80 month vs 63 months,P=0.483, 49 months vs 48 months,P=0.781, and 51 months vs 49 months,P=0.635）. However,in the G1 patients,significantly difference was detected in the median survival time between the two groups （77 vs 51 months,P=0.037）. Conclusion Laparoscopic surgery should be used as a routine surgical approach for patients with stage Ⅰ EMC considering its minimal invasiveness and promising prognosis.

关 键 词：子宫内膜癌 腹腔镜手术 开腹手术 预后 

分 类 号：R737.33[医药卫生—肿瘤]