腹腔镜子宫内膜癌分期手术的临床效果观察  

Outcomes of Staging Laparoscopic Surgery for Endometrial Cancer

作　　者：张海艳[1] 李立安[2] 范文生[2] 李亚里[2] 孟元光[2] 

机构地区：[1]南开大学医学院,天津300071 [2]解放军总医院妇产科,北京100853

出　　处：《中国微创外科杂志》2012年第5期425-428,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：国家自然科学基金项目(30872749)

摘　　要：目的探讨腹腔镜子宫内膜癌分期手术的临床疗效及预后。方法 2005年1月～2011年3月243例子宫内膜癌行分期手术,其中腹腔镜分期手术75例,开腹分期手术168例,比较2组手术时间、术中出血量、并发症、术后胃肠功能恢复时间、术后住院时间、生存情况。结果腹腔镜组清扫淋巴结总数显著多于开腹组[(27.1±11.2)枚vs.(22.6±9.7)枚(t=3.182,P=0.002)];腹腔镜组术中出血量(315.1±108.0)ml显著少于开腹组(851.6±246.9)ml(t=-18.047,P=0.000);腹腔镜组排气时间(1.8±0.7)d显著早于开腹组(2.6±0.8)d(t=-7.475,P=0.000);腹腔镜组尿管拔除时间(8.5±5.3)d明显早于开腹组(12.5±6.0)d(t=-4.971,P=0.000);腹腔镜组术后住院时间(13.7±7.1)d与开腹组(14.9±6.5)d无统计学差异(t=-1.292,P=0.198);2组生存率和无瘤生存率无统计学差异(χ2=0.351,P=0.553;χ2=0.000,P=0.998)。结论腹腔镜子宫内膜癌分期手术的疗效与开腹手术相当,但腹腔镜手术淋巴结切除数量多,出血量少,排气时间短,更具微创价值。Objective To explore the efficacy and prognosis of laparoscopic staging surgeries in the treatment of endometrial cancer. Methods Retrospective analysis was made on 243 patients with endometrial cancer, who received staging surgery from January 2005 to March 2011. Laparoscopic surgery was carried out in 75 of the patients, and the other 168 patients received open surgery. The operation time, intraoperative blood loss, complications, postoperative recovery time of gastrointestinal function, postoperative hospital stay, and survival of the two groups were compared. Results The laparoscopy group had more removed lymph nodes, less intraoperative blood loss, quicker recovery time of gastrointestinal function, shorter urinary drainage time than the open group [27.1 ±11.2 vs. 22.6 ±9.7, t=3.182, P=0.002; （315.1 ±108.0）ml vs. （851.6±246.9）ml, t= -18.047, P= 0.000; （1.8±0.7）d vs. （2.6±0.8）d, t= -7.475, P=0.000; and （8.5 ±5.3）d vs. （12.5 ±6.0）d, t= -4.971, P= 0. 000]. No significant difference was observed in the postoperative hospital stay, survival rate, and rate of survival without tumor [（13.7 ±7.1）d vs. （14.9±6.5）d, t= -1.292, P=0.198;X2 =0.351, P=0.553; and Х^2=0.000, P=0.998]. Conclusion Although there is no significant difference in survival and recurrence rates between the two approaches for endometrial cancer, laparoscopic surgery is superior to open surgery in more removed lymph node, less hemorrhage, and shorter recovery time of gastrointestinal function.

关 键 词：腹腔镜 子宫内膜癌 开腹手术 

分 类 号：R737.33[医药卫生—肿瘤]