腹腔镜筋膜外全子宫及双侧附件切除术治疗肥胖型子宫内膜癌的效果及安全性  

Efficacy and safety of laparoscopic extrafascial panhysterectomy combined with bilateral appendectomy in the treatment of endometrial cancer in obese women

作　　者：李梅芳 李雷[2] 刘风花[2] Li Meifang;Li Lei;Liu Fenghua(Department of Gynecology,Xinxiang First People's Hospital,Xinxiang 453000,China;Department of Gynecology and Oncology,Henan Cancer Hospital,Zhengzhou 450008,China)

机构地区：[1]河南省新乡市第一人民医院妇科,453000 [2]河南省肿瘤医院妇瘤科,郑州450008

出　　处：《中国实用医刊》2020年第21期52-55,共4页Chinese Journal of Practical Medicine

摘　　要：目的:探究腹腔镜筋膜外全子宫及双侧附件切除术治疗肥胖型子宫内膜癌的效果及安全性。方法:回顾性分析2016年10月至2019年10月于新乡市第一人民医院接受治疗的60例肥胖型子宫内膜癌患者的临床资料,根据手术方式进行分组,开腹组21例行开腹全子宫及双侧附件切除术,腹腔镜组39例行腹腔镜筋膜外全子宫及双侧附件切除术。比较两组患者手术情况(手术时间、术中出血量、术后肛门恢复排气时间、留置导尿管时间)及术后并发症发生情况,比较两组患者术前及术后1 d的C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,比较两组患者术后6个月的复发率、存活率及远处转移率。结果:腹腔镜组手术时间、术中出血量、术后肛门恢复排气时间、留置导尿管时间均少于开腹组(P均<0.05);腹腔镜组切口脂肪液化、尿道感染发生率均低于开腹组(P均<0.05),两组患者淋巴囊肿、切口感染、尿潴留发生率比较差异未见统计学意义(P均>0.05)。术后1 d,两组CRP、IL-6、TNF-α水平均较术前升高,且腹腔镜组低于开腹组(P<0.05);两组患者复发、存活、远处转移率比较差异未见统计学意义(P>0.05)。结论:腹腔镜筋膜外全子宫及双侧附件切除术治疗肥胖型子宫内膜癌能缩短手术时间并减少术中出血量,不增加术后并发症发生率,对患者术后炎症反应影响程度较低,且术后短期内未出现复发转移。Objective:To investigate the efficacy and safety of laparoscopic extrafascial panhysterectomy and bilateral appendectomy in the treatment of endometrial cancer in obese women.Methods:The clinical data of 60 obese women with endometrial cancer who were treated in Xinxiang First People’s Hospital from October 2016 to October 2019 were retrospectively analyzed.The patients were grouped according to the surgical methods.Twenty-one patients in laparotomy group were given laparotomy panhysterectomy combined with bilateral appendectomy,and 39 patients in laparoscopic group were given laparoscopic extrafascial panhysterectomy combined with bilateral appendectomy.The surgical conditions(operative time,intraoperative blood loss,postoperative anal exhaust recovery time,indwelling catheter time)and occurrence of postoperative complications were compared between the two groups.The levels of C-reactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)were compared between the two groups before surgery and on 1 d after surgery.And the recurrence rate,survival rate and distant metastasis rate were compared between the two groups 6 months after surgery.Results:The operative time,intraoperative blood loss,postoperative anal exhaust recovery time,and indwelling catheter time in laparoscopic group were all shorter than those in laparotomy group(all P<0.05).The incidences of incision fat liquefaction and urethral infection in laparoscopic group were lower than those in laparotomy group(all P<0.05).And there was no significant difference in the lymphocyst,incision infection,or urinary retention between the two groups(all P>0.05).The levels of CRP,IL-6 and TNF-αin the two groups were higher than those before surgery,and the levels in laparoscopic group were lower than those in laparotomy group 1 d after surgery(all P<0.05).There were no significant differences in the recurrence rate,survival rate,or distant metastasis rate between the two groups(P>0.05).Conclusions:Laparoscopic extrafascial panhysterectomy combin

关 键 词：子宫内膜癌 腹腔镜 子宫 双侧附件切除术 安全性 

分 类 号：R737.33[医药卫生—肿瘤]