腹腔镜下广泛子宫切除+盆腔淋巴结清扫术与传统开腹手术在早期子宫恶性肿瘤治疗中的比较  

Comparison of laparoscopic radical hysterectomy and pelvic lymphadenectomy with traditional laparotomy for the treatment of early uterine malignancy

作　　者：杨菁[1] 贺敏[1] 邢辉[2] 李琳[2] 李仙仙[2] 周敏[2] 

机构地区：[1]武汉大学人民医院生殖医学中心,湖北武汉430000 [2]湖北省襄阳市中心医院妇产科,湖北襄阳441021

出　　处：《中国医药导报》2014年第28期47-50,共4页China Medical Herald

摘　　要：目的对比分析腹腔镜下广泛子宫切除＋盆腔淋巴结清扫术与传统开腹手术治疗子宫恶性肿瘤的近期效果及应用价值。方法对襄阳市中心医院2010年6月～2013年3月收治的43例早期子宫恶性肿瘤患者进行腹腔镜下广泛性全子宫切除术＋盆腔淋巴结清扫术（腹腔镜组），并和同期43例经腹行广泛性全子宫切除术＋盆腔淋巴结清扫术的早期子宫恶性肿瘤患者（开腹组）进行对照，比较两种术式的手术时间、术中出血量、清扫淋巴结数目、术中及术后并发症等。结果与开腹组相比，43例腹腔镜组的患者术中失血量少f（336．28±240．49）mL比（479．07±317．02）mL，P〈0．051、清除淋巴结数目多[（18．95±3．87）个比（17．02±3．89）个，P＜0．05]、术后肛门排气时间短[（1．43±0．40）d比（2．29±0．44）d，P＜0．05]、术后住院天数少[（9．63±1．93）d比（11．14±3．36）d，P＜0．05]以及输血比例低[（16．28％）比（41．86％），P＜0．05]，差异有统计学意义；手术时间较开腹组长，但差异无统计学意义[（231．04±64．33）min比（209．30±45．07）rain，P＞0．05]。结论在早期子宫恶性肿瘤的手术方式中，与传统开腹手术相比，腹腔镜组具有同样的有效性和安全性，同时减少了术中出血量及术后并发症，减少了手术创伤，缩短了住院时间，术后患者恢复快。为妇科恶性肿瘤应用微创手术治疗提供了良好的应用前景。Objective To compare the application value and efficacy of laparoscopic radical hysterectomy and pelvic lymphadenectomy with traditional laparotomy for the treatment of uterine malignancies. Methods From June 2010 to March 2013 in Xiangyang Central Hospital, 43 cases of patients with early uterine malignancy were scheduled for laparoseopic radical hysterectomy and pelvic lymphadenectomy （laparoscopie group） as treatment, at the same period 43 cases of patients with early uterine malignancy were recruited to be the laparotomy group who were given traditional laparotomy. The time of surgery, amount of bleeding, number of dissected pelvic lymph nodes, complication of intraoperative and postoperative of the two groups were compared. Results Compared with the laparotomy group, 43 patients in the laparoscopic group showed less intraoperative blood loss [（336.28±240.49） mL vs （479.07±317.02） mL, P 〈0.05], more remove lymph node number [（18.95±3.87） vs （17.02±3.89）, P 〈0.05], shorter postoperative anal exhaust time [（1.43±0.40） d vs （2.29±0.44） d, P 〈0.05], less postoperative hospital stay [（9.63±1.93） d vs （11.14±3.36） d, P 〈0.05], lower proportion of blood transfusion [（16.28%） vs （41.86%）, P 〈0.05], the differences were statistically significant; the longer operative time [（231.04±64.33） min vs （209.30＋45.07） min, P 〉0.05], but the differenee was not statistically signifieant. Conclusion The study compares the therapeutic effieaey of laparoscopic surgery and traditional laparotomy for the early uterine malignancy, finds that the laparoscopic surgery has the same efficacy and safety, while reducing the amount of bleeding, the postoperative complications and the surgical trauma, shorting the hospital stay, fasting the postoperative reeovery, thus provides a good prospect of micro invasive surgery for the gynecological malignancices.

关 键 词：子宫恶性肿瘤 腹腔镜手术 广泛子宫切除 盆腔淋巴结清扫 

分 类 号：R737.33[医药卫生—肿瘤]