腹腔镜与开腹手术治疗宫颈癌患者的淋巴脉管受累情况比较  

Comparison of lymph-vascular space invasion in patients with cervical cancer between laparoscopy and laparotomy

作　　者：赵万成[1] 杨清[1] ZHAO Wancheng;YANG Qing(Department of Obstetrics and Gynecology,Shengjing Hospital of China Medical University,Liaoning Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院妇产科,辽宁沈阳110004

出　　处：《现代肿瘤医学》2021年第10期1757-1760,共4页Journal of Modern Oncology

摘　　要：目的:通过分析对比腹腔镜及开腹手术治疗宫颈癌患者的淋巴脉管受累情况,探讨腹腔镜手术是否对患者淋巴脉管受累存在不良影响。方法:收集2013年-2018年于中国医科大学附属盛京医院行宫颈癌手术并经病理确认是否存在淋巴脉管受累患者(FIGO分期为Ⅰa2-Ⅱa2期)共计1087例,根据手术方式将其分为腹腔镜组及开腹组,并分析其临床资料。结果:腹腔镜组及开腹组分别为148例及939例,两组淋巴脉管受累比例分别为31.76%(47/148)及33.23%(312/939),两组总体淋巴脉管受累情况并无明显统计学差异(P=0.724)。腹腔镜组和开腹组在淋巴结转移癌、间质浸润深度、分化程度及宫旁受累等方面存在淋巴脉管受累情况无明显差异,但腹腔镜组在宫颈癌灶>4 cm时(即Ⅰb2及Ⅱa2期)存在淋巴脉管受累的病例较开腹组明显增加(P=0.005),另存在淋巴结转移癌的患者中淋巴脉管受累比例明显高于无淋巴结转移癌者(P=0.000)。结论:腹腔镜下广泛性子宫切除手术在宫颈癌灶>4 cm时较开腹手术可能增加了患者淋巴脉管受累的风险。Objective:A case control study of cervical cancer between laparoscopy and laparotomy was done to determine the influence of laparoscopy on the lymph-vascular space invasion(LVSI).Methods:2013-2018,1 087 patients of FIGO stage Ⅰa2-Ⅱa2 cervical cancer were abstracted, whether LVSI existed was confirmed, and the patients were divided into two groups, including laparoscopy(148 cases) and laparotomy(939 cases).Results:There was no statistical difference(P=0.724) regarding the total incidence(31.76% vs 33.23%) between 47 patients of positive LVSI in 148 cases undergoing laparoscopy and 312 patients of positive LVSI in 939 cases undergoing laparotomy.There was also no significant difference in lymph node metastatic carcinoma, interstitial infiltration depth, and differentiation degree between the patients of positive LVSI undergoing laparoscopy and the patients undergoing laparotomy, but the positive LVSI patients with cervical cancer lesions larger than 4 cm undergoing laparoscopy was larger than that undergoing laparotomy(P=0.005).The patients with lymph node metastatic carcinoma had more positive LVSI(P=0.000).Conclusion:Laparoscopic radical hysterectomy may increase the risk of LVSI in the patients with cervical cancer lesions larger than 4 cm undergoing laparoscopy than laparotomy.

关 键 词：腹腔镜手术 淋巴脉管受累 宫颈癌 广泛性子宫切除手术 

分 类 号：R737.33[医药卫生—肿瘤]