系统性淋巴结清扫术在子宫内膜癌治疗中的意义及安全性  

Significance and safety of systematic lymphadenectomy in the treatment of patients with endometrial cancer

作　　者：邵佳[1] 何爱琴[1] 陈曾燕[1] 

机构地区：[1]南通大学附属肿瘤医院妇科,江苏南通226361

出　　处：《实用临床医药杂志》2014年第17期91-93,99,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨系统性淋巴结清扫术对子宫内膜癌患者预后的影响及安全性。方法回顾性分析2007年1月—2012年3月本院收治的54例子宫内膜癌患者临床资料。根据手术范围的不同分为2组,A组为行次广泛全子宫+双附件切除+盆腔淋巴结清扫术30例,B组为行次广泛全子宫+双附件切除+系统性盆腔、腹主动脉旁淋巴结清扫术24例。治疗结束后比较2组患者的预后及术后并发症情况。结果 A组2年复发转移率为40%,B组2年复发转移率为12.5%,差异有统计学意义(P<0.05)。A、B组2年生存率分别为70.0%和91.7%,差异有统计学意义(P<0.05)。B组与A组比较,不全性肠梗阻的发生率明显增加(P<0.05),但术后体温恢复时间及下肢水肿、淋巴囊肿、深静脉血栓、输尿管尿瘘的发生率均无显著差异(均P>0.05)。结论系统性盆腔、腹主动脉旁淋巴结清扫可以提高子宫内膜癌患者的生存率并改善预后,术后并发症的发生率有所增加,但仍在可控范围之内。Obj ective To explore the effect and safety of systematic lymphadenectomy on the prognosis of patients with endometrial cancer.Methods 54 patients with endometrial cancer were divided into two groups according to the type of surgery.Group A （n= 30）was treated with modified radical hysterectomy plus bilateral salpingo-oophorectomy and pelvic lymphadenectomy, while group B （n= 24 ）was treated with modified radical hysterectomy plus bilateral salpingo-oophorectomy and systematic pelvic as well as para-aortic lymphadenectomy.Prognosis and post-operative complications were compared between two groups.Results The two-year recurrence and metastasis rate in group A was 40%,which was significantly higher than 12.5%in group B （P〈0.05）.The two-year overall survival rates in group A and group B were 70.0%and 91.7%re-spectively,and there was significant difference between two groups （P〈0 .05 ）.Incidence rate of incomplete intestinal obstruction in group B was significantly higher than that in group A （P 〈0.05）.There were no significant differences in the incidence rates of lymphedema,lymphocyst, deep vein thrombosis and urethral fistula between two groups （P〉0 .05 ）.Conclusion Systematic pelvic and para-aortic lymphadenectomy can improve the survival rate and prognosis of patients with endometrial carcinoma,and the incidence rate of postoperative complications can be restrained in controllable scope.

关 键 词：子宫内膜癌 系统性盆腔 腹主动脉旁淋巴结清扫术 预后 并发症 

分 类 号：R737.33[医药卫生—肿瘤]