腹腔镜下早期卵巢癌全面分期手术的随访观察  

Follow-up study of comprehensive laparoscopic surgical staging in early ovarian cancer

作　　者：余炜昶[1] 王燕[1] 郎雁[1] 黄燕明[1] 段洁[1] 杜欣[1] 金晶[1] 李红英[1] 陈璐[1] 冯同富[1] 

机构地区：[1]湖北省妇幼保健院妇科,湖北武汉430070

出　　处：《中国内镜杂志》2016年第10期37-42,共6页China Journal of Endoscopy

摘　　要：目的随访腹腔镜治疗早期卵巢癌（EOC）的临床效果，探讨腹腔镜EOC全面分期手术的有效性和安全性。方法回顾性分析2012年5月-2015年8月在湖北省妇幼保健院手术治疗的EOC患者42例。其中，腹腔镜组19例，开腹组23例，比较两组手术时间、术中出血量、淋巴结切除数目、术后排气时间、住院时间，术后并发症发生率、分期上升率及术后化疗率。结果两组患者均顺利完成手术，未发生术中并发症。与开腹组比较，腹腔镜组术中出血量明显减少（124.7±63.5）vs（328.7±155.5）ml（P 〈0.05），术后肛门排气时间（1.5±0.5）vs（2.7±0.9）d及术后住院时间（8.9±1.5）vs（14.3±3.8）d均明显缩短（P 〈0.05）。两组手术时间、淋巴结切除数目、术后并发症发生率、分期上升率和术后化疗率差异均无统计学意义（P 〉0.05）。随访7～46个月，平均24.6个月，两组复发率、死亡率差异无统计学意义（P 〉0.05）。腹腔镜组和开腹组的无瘤生存率分别为94.7%和91.3%，总生存率分别为94.7%和100.0%。结论EOC腹腔镜手术具有出血少、创伤小和恢复快等优势，近期疗效确切，安全可行。ObjectiveTo observe the efficacy of laparoscopic staging in early ovarian cancer （EOC） and evaluate its feasibility and safety. MethodsThe outcomes of 42 patients with EOC who underwent laparoscopic （LPS group, n =19） or laparotomic surgical staging （LPT group, n =23） from May 2012 to August 2015 were retrospectively analyzed. The parameters including operation time, intraoperative blood loss, number of resected lymph nodes, gastrointestinal recovery time, hospital stay, postoperative complications, chemotherapy and postoperative upstaging rate were compared between the two groups. ResultsAll operations completed successfully in two groups, and no intraoperative complications were observed. LPS group had less intraoperative blood loss （124.7 ± 63.5） vs （328.7 ± 155.5） ml, shorter gastrointestinal recovery time （1.5 ± 0.5） vs （2.7 ± 0.9） d and shorter hospital stay （8.9 ± 1.5） vs （14.3 ± 3.8） d when compared with LPT group （P 〈0.05）. No significant difference was found in operation time, number of resected lymph nodes, postoperative complications, chemotherapy and postoperative upstaging rate between the two groups （P 〉0.05）. A total of 42 patients were followed up for 7～46 months, with an average of 24.6 months. There was no significant difference in the recurrent and survival rate between the two groups （P 〉0.05）. The disease-free survival and overall survival in LPS group is 94.7% and 94.7%, respectively. In LPT group is 91.3% and 100.0%. ConclusionLaparoscopy and laparotomy had similar surgical staging adequacy and accuracy, whereas laparoscopy shows more favorable operative outcomes, such as less blood loss during the operation, minor trauma and more rapid recovery. Laparoscopic surgical staging is feasible and safe for EOC in a short term, and its long-term outcomes are to be further investigated.

关 键 词：早期卵巢癌 腹腔镜手术 开腹手术 随访研究 

分 类 号：R737.31[医药卫生—肿瘤]