腹腔镜与开腹手术在宫颈癌腹主动脉旁淋巴结清扫术的安全性和生存结局比较  

A comparison of efficacy and safety of laparoscopic surgery versus laparotomy surgery to para-aortic lymphadenectomy for cervical cancer

作　　者：陈雨柔[1] 张蔚[1] 吴寒舒 吴婉蓉[1] 刘福林[1] 

机构地区：[1]武汉大学人民医院妇产科,武汉430060

出　　处：《现代妇产科进展》2017年第10期727-730,共4页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨腹腔镜与开腹手术在宫颈癌腹主动脉旁淋巴结清扫术的安全性和生存结局比较。方法:回顾分析2015年1月至2016年12月于武汉大学人民医院行腹主动脉旁淋巴结清扫的86例宫颈癌患者的临床资料。其中50例行腹腔镜术(腹腔镜组),36例行开腹术(开腹组)。比较两组患者的手术时间、术中出血量、腹主动脉旁淋巴结清扫数、术中及术后并发症、术后肛门排气时间、总住院时间、预后情况。结果:两组患者的手术时间比较,差异无统计学意义(P>0.05)。与开腹组比较,腹腔镜组的术中出血量明显减少,术后肛门排气时间早,术后总住院时间短,淋巴结清扫数多,差异均有统计学意义(P<0.05)。两组的术中输尿管损伤、血管损伤、术后淋巴囊肿、尿潴留、肠梗阻、深静脉血栓、呼吸系统感染发生率比较,差异均无统计学意义(P>0.05)。开腹组切口液化4例,腹腔镜组无切口液化,差异有统计学意义(P<0.05)。腔镜组与开腹组患者的远期临床预后并无明显差异。结论:腹腔镜下腹主动脉旁淋巴结清扫手术用于宫颈癌治疗有较好的安全性,值得临床推广。Objective： To access the clinical value of laparoscopic surgery in choosing treatment of para-aortic lymphadenectomy for patients with cervical cancer.Methods： Retrospective analysis was performed on clinical and pathological data collected from 86 patients undergoing cervical cancer from Jan.2015 to Dec.2016,patents divided into laparoscopic surgery group and laparotomy group according to inclusion criteria.Results： The laparoscopic surgery had lesser amount of intraoperative bleeding（P〈 0. 05）,shorter hospital stay time（P〈 0. 05）,shorter postoperative anal exhaust time（P〈0.05）,more lymph node dissection（P〈0.05）,lower rate of Incision liquefaction（P 〈0. 05）. There was no significance difference in operation time（P 〈0.05）,the rate of postoperative complications（P〈0.05）,such as Ureteral injury,vascular injury,postoperative lymphatic cyst,urinary retention,intestinal obstruction,deep vein thrombosis,respiratory infection.Conclusion： The laparoscopic para-aortic lymphadenectomy in treating cervical cancer is safe effectually compared to laparotomy surgery. Based on improved peri-operative outcomes,the use of minimally-invasive techniques is advocated where appropriate.

关 键 词：宫颈癌 腹腔镜 腹主动脉旁淋巴结清扫 

分 类 号：R737.33[医药卫生—肿瘤]