496例早期宫颈鳞癌患者腹腔镜与开腹手术的手术并发症对比及生存分析  

Comparison of the Intraoperative and Postoperative Complications and Survival between Laparoscopy and Open Radical Hysterectomy in the Treatment of Early-stage of Cervical Cancer

作　　者：朱悦汀[1] 刘琴[1] 李华[1] 帕提曼.米吉提 古扎丽努尔.阿不力孜 

机构地区：[1]新疆医科大学第三附属医院妇外五科,新疆乌鲁木齐830011

出　　处：《现代生物医学进展》2017年第16期3164-3170,共7页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81272335)

摘　　要：目的:比较早期宫颈鳞癌患者腹腔镜宫颈癌根治术(laparoscopic radical hysterectomy,LRH)与开腹宫颈癌根治术(open radical hysterectomy,ORH)的手术并发症的发生情况以及患者的生存情况。方法:回顾性研究2008年1月至2012年12月新疆肿瘤医院收治的IB-IIA期宫颈癌患者ORH和LRH的手术并发症的发生情况及生存情况。结果:ORH组术中出血量明显多于LRH组[(431.15±126.89)m L vs.(141.83±53.12)m L,P<0.001];ORH组淋巴结切除个数明显少于LRH组[(22.91±8.38)枚vs.(26.41±10.24)枚,P<0.001];ORH组和LRH组术中并发症发生率及术后并发症发生率比较无明显统计学意义(P>0.05)。ORH组1、3、5年无病生存率分别为95.08%、87.23%、72.55%;LRH组1、3、5年无病生存率分别为98.80%、89.53%、77.30%,两组术后无病生存差异无统计学意义(P=0.056),但当肿瘤直径≥4 cm时LRH组的无病生存率高于ORH组且差异有统计学意义(P=0.014)。结论:早期宫颈癌患者行腹腔镜下癌根治术时手术并发症少,术后恢复快。对于肿瘤直径≥4 cm的患者采用腹腔镜宫颈癌根治术可能会提高患者无复发生存率。Objective： To compare the incidence of postoperative complications and long-term survival outcomes between laparoscopic radical hysterectomy （LRH） and open radical hysterectomy （ORH） in the treatment of early-stage of cervical cancer. Methods： Patients with stage IA2 to IIA cervical cancer who underwent ORH and LRH in Xinjiang Provincial Tumor Hospital from January 2008 to December 2012 were reviewed. Results： The intraoperative blood loss of ORH group was obviously higher than that of the LRH group [（431.15± 126.89）mL vs.（141.83± 53.12）mL, P〈0.001], while the number of cleared lymph, node was obviously lower[ （22.91 ±8.38） vs. （26.41± 10.24）, P 〈 0.001]. No significant difference was found in the intraoperative and postoperative complication between two groups （P〉0.05）. The 1, 3, 5-year disease free survival （DFS） rate of ORH and LRH group were 95.08%, 87.23%,72.55% and 98.80%, 89.53%, 77.30% respectively, There was no statistically significant difference between the two groups in the DFS rate（P=0. 056）, but the DFS rate of LRH group was higher than that of the ORH group when the tumor size〉 4 cm （P=0.014）. Conclusion： LRH was an oncologically safe alternative to ORH and was associated with fewer postoperative complication and earlier recovery, LRH might contribute to higher DFS rate of early-stage of cervical cancer patients whose of early-stage of cervical cancer.

关 键 词：早期宫颈癌 腹腔镜下根治性子宫切除 开腹根治性子宫切除 术中及术后并发症 无病生存 

分 类 号：R737.33[医药卫生—肿瘤]