腹腔镜下卵巢癌全面分期手术的可行性和临床意义  

The feasibility of comprehensive staging surgery via laparoscopic operation in patients with ovarian cancer and its clinical significance

作　　者：张正茂[1] 刘洋[1] 李佳[1] 邱红兵[1] 康山 单保恩[2] 

机构地区：[1]河北医科大学第四医院妇科,河北石家庄050011 [2]河北医科大学第四医院科研中心,河北石家庄050011

出　　处：《肿瘤》2014年第1期55-59,共5页Tumor

摘　　要：目的:探讨腹腔镜下对卵巢癌尤其是早期卵巢癌进行全面分期手术的可行性及其临床意义。方法:回顾性分析2010年1月—2013年1月本科收治的35例(Ⅰ期29例,Ⅱ期4例,Ⅲ期2例)卵巢癌患者的病历资料,其中15例行卵巢癌腹腔镜下全面分期手术,20例行卵巢癌开腹全面分期手术。观察并比较两组患者的术中及术后情况以及生存情况。结果:15例腹腔镜手术组患者均顺利完成手术,未发生围手术期并发症。腹腔镜手术组患者的术中出血量和术后镇痛泵使用率均低于开腹手术组,差异有统计学意义(P<0.05);两组的手术时间、盆腹腔淋巴结清扫数、术后胃肠功能恢复时间、术后并发症发生率、术后复发率、术后分期上升发生率、术后住院时间、住院费用和术后化疗率的差异均无统计学意义(P>0.05)。两组的累计生存率差异无统计学意义(P>0.05)。结论:在腹腔镜下对卵巢癌尤其是早期卵巢癌进行全面分期手术是安全而可行的,具有出血少、创伤小和术后恢复快等优点。Objective： To explore the feasibility and safety of comprehensive staging surgery via laparoscopic operation and its clinical significance. Methods： A retrospective analysis of medical records was conducted in 35 inpatients diagnosed of ovarian cancer （stage I, n = 29; stageII, n = 4; stage III, n = 2） in Department of Gynecology of Fourth Hospital of Hebei Medical University between January 2010 and January 2013. Of the 35 patients, 15 underwent comprehensive staging operation via laparoscopic operation and 20 via open operation. The general conditions during and after operation and the postoperative survival were observed and compared between the two groups. Results： All operations completed successfully in 15 patients in the laparoscopic operation group, and no perioperative complications were observed. The intraoperative blood loss and the rate of postoperative analgesia in the laparoscopic operation group were both less than those in the open operation group （P 〈 0.05）, but the differences in duration of operation, number of abdominal and pelvic lymph nodes resected, recovery time of gastrointestinal function, rate of postoperative complications, rate of postoperative recurrence, rate of increase in pathological stage, hospitalization expenses, duration of hospital stay after operation and the rate of chemotherapy after operation were not statistically significant between the two groups （P 〉 0.05）. There was also no significant difference in the cumulative survival rate between the two groups （P 〉 0.05）. Conclusion： Comprehensive staging operation for ovarian cancer especially for early-stage cancer is feasible and safe. It has the merits of smaller wound, less blood loss during the operation and more rapid recovery.

关 键 词：卵巢肿瘤 腹腔镜 全面分期手术 

分 类 号：R737.31[医药卫生—肿瘤]