腹腔镜下和经腹广泛子宫切除及盆腔淋巴结清扫术治疗早期子宫恶性肿瘤的近期疗效分析  

Short Term Results of Laparoscopic or Laparotomy Radical Hysterectomy and Pelvic Lymphadenectomy for Early Uterine Malignancy

作　　者：沈怡[1] 王泽华[1] 

机构地区：[1]华中科技大学附属协和医院,湖北武汉430022

出　　处：《实用妇产科杂志》2010年第1期48-51,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨腹腔镜下广泛子宫切除加盆腔淋巴结清扫术治疗子宫恶性肿瘤的近期疗效及应用价值。方法:对协和医院妇产科2008年3月至2009年4月间的70例早期子宫恶性肿瘤患者行腹腔镜下广泛子宫切除加盆腔淋巴结清扫术(TLRH+LPL组),并与同期48例经腹广泛子宫切除术和淋巴结清扫术(ARH+APL组)的病例作为对照,比较两种术式的术中、术后情况及并发症等。结果:行腹腔镜手术的70例患者,有2例中转开腹,中转率为2.9%。TLRH+LPL组在手术时间、术中出血量、淋巴结切除数目和术后体温恢复正常平均时间上与ARH+APL组相比,具有明显优势,差异均有高度统计学意义(P<0.01);但膀胱功能恢复时间及术后并发症的发生率,两组比较差异无统计学意义(P>0.05)。结论:腹腔镜下广泛子宫切除加盆腔淋巴结清扫术具有同常规的经腹手术同样的安全性和有效性,同时缩短了手术时间,减少了手术创伤,为微创手术治疗妇科恶性肿瘤提供了良好的应用前景。Objective：The short term results of laparoscopic radical hysterectomy and pelvic lymph nodes dissection for early uterine malignancy were investigated. Methods：70 patients with early malignant uterine tumor who underwent a laparoscopic radical hysterectomy and pelvic lymph nodes dissection （TLRH ＋ LPL ） were retrospectively reviewed. At the samt time, 48 patients were recruited to be the control group who had laparotomy radical hysterectomy and pelvic lymph nodes dissection（ARH ＋ APL）. Intraoperative and postoperative situations and complications between these two groups were analyzed. Results：70 patients under- went laparoscopic operation, but two cases changed to laparotomy（ transfer rate 2.9% ）. The mean operation time, blood loss, number of dissected pelvic lymph nodes and postoperative temperature recovery time of TLRH ＋ LPL group was significantly different from ARH ＋ APL group （ P 〈 0.01 ）, while there were no difference between these two groups on bladder function recovery time and occurance of postoperative complications. Conclusions：TLRH ＋ LPL has the same feasibility and safety with ARH ＋ APL, less invasive to the tissue, thus offers a good option of microinvasive therapy for female malignant tumor.

关 键 词：腹腔镜手术 广泛子宫切除 子宫恶性肿瘤 

分 类 号：R737.33[医药卫生—肿瘤]