宫颈癌腹腔镜根治术与开放性手术的疗效分析  

Comparative analysis of laparoscopic radical hysterectomy and open surgery for cervical cancer

作　　者：杨军文[1] 倪观太[1] 

机构地区：[1]皖南医学院第一附属医院弋矶山医院妇产科,安徽芜湖241001

出　　处：《皖南医学院学报》2017年第3期247-249,共3页Journal of Wannan Medical College

摘　　要：目的:观察宫颈癌(FIGO分期Ⅰa2~Ⅱa)患者应用腹腔镜根治术与开放性手术疗效,为合适宫颈癌术式选择提供依据。方法:选取2012~2014年在弋矶山医院妇科住院并行宫颈癌根治术的82例患者(FIGO分期Ⅰa2~Ⅱa)作为研究对象,按手术方法分为观察组(腹腔镜手术)和对照组(开放性手术)各41例,比较两组围术期情况、病理及随访资料。结果:与对照组比较,观察组手术时间缩短(t=3.735,P=0.000)、术中出血减少(t=3.539,P=0.000)、肛门排气时间及住院时间均缩短(t=3.252、4.210,P均<0.01);观察组清扫淋巴结数量(23.60±6.82)枚多于对照组(20.08±6.39)枚,差异有统计学意义(t=2.412,P=0.018);术后生活质量EORTC QLQCA30量表评分观察组72.44±9.78,对照组66.15±8.72,两组差异有统计学意义(t=3.074,P=0.003);但两组并发症发生率、术后复发生存率、子宫主骶韧带及阴道切除长度比较差异均无统计学意义(χ~2=0.901、0.311、0.456,t=0.216、1.140、1.966,P均>0.05)。结论:腹腔镜宫颈根治术具有微创、安全、临床疗效佳等优势,是治疗宫颈癌可靠有效的方法,值得推广应用。Objective：To compare the efficacies of laparoscopic radical hysterectomy and open surgery for cervical cancer（Ⅰa2-Ⅱa by staging system as Federation Internationale de Gynecologie et d＆#39;Obstetrique,FIGO） for evidences to plan optimal surgical options in treatment of cervical cancer.Methods：Eighty-two patients with early cervical carcinoma were included in our department between 2012 and 2014,and allocated to observational group（laparoscopic radical hysterectomy）and control group（open radical hysterectomy）（n=41 for each group）.The two groups were compared concerning perioperative information,pathological findings and follow-up records.Results：Patients in the observational group had shorter operative time,lower intraoperative blood loss,early anus exhaust,reduced hospital stay and more lymph nodes[（23.60±6.82）vs.（20.08±6.39）] removed in operation than the controls（t=3.735,P=0.000;t=3.539,P=0.000;t=3.252,t=4.210,P〈0.01,respectively）.The difference was significant（t=2.412,P=0.018）.Evaluation of the postoperative quality of life by EORTC QLQ-C30 scoring system indicated（72.44±9.78） for the observational group and（66.15±8.72） for the control group.The difference was significant（t=3.074,P=0.003）.However,the two groups were not significantly different regarding incidence of complications,postoperative recurrence and survival rate,incised length of uterosacral ligament and vagina（χ2=0.901,0.311 and 0.456;t=0.216,1.140 and 1.966,respectively,all P〉0.05）.Conclusion：Laparoscopic cervical radical hysterectomy can be wider clinical recommendation for cervical cancer because of its minimal invasion,safety,better clinical efficacy and reliability.

关 键 词：宫颈癌 腹腔镜 开放性手术 疗效 

分 类 号：R737.33[医药卫生—肿瘤]