腹腔镜与开放式子宫根治术治疗局部晚期宫颈癌的疗效:倾向评分匹配研究  

Clinical results of laparoscopic versus open radical hysterectomy of locally advanced cervical cancer:a propensity score matching study

作　　者：关德凤 黄涛 张钗红 姚广 杨永秀[1,2,3] Guan De-feng;Huang Tao;Zhang Chai-hong;Yao Guang;Yang Yong-xiu(The First School of Clinical Medicine,Lanzhou University,Lanzhou 730000,China;Department of Obstetrics and Gynecology,The First Hospital of Lanzhou University,Lanzhou 730000,China;Key Laboratory for Gynecologic Oncology Gansu Province,The First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730000 [2]兰州大学第一医院妇产科,甘肃兰州730000 [3]兰州大学第一医院甘肃省妇科肿瘤重点实验室,甘肃兰州730000

出　　处：《兰州大学学报（医学版）》2021年第3期37-40,共4页Journal of Lanzhou University（Medical Sciences）

基　　金：中央高校基本科研业务费专项基金资助项目(561219009);兰州大学第一医院院内基金项目(ldyyyn2018-36);兰州大学第一临床医学院卓越计划项目(20190060099)。

摘　　要：目的评估腹腔镜子宫根治术(LRH)与开放式子宫根治术(ORH)治疗局部晚期宫颈癌(LACC)的价值。方法分析2010年1月—2017年12月在兰州大学第一医院接受LRH或ORH的506例患者的数据,使用12个协变量进行倾向评分匹配(PSM)分析以平衡患者的基线特征,通过χ^(2),Mann-Whitney U检验分析2组患者的手术效果、并发症、复发率和生存率。结果经PSM后,进一步分析212例患者(106 LRH和106 ORH)的均衡队列。与ORH组相比,LRH组检索到的盆腔淋巴结数量更多(P=0.002)、手术时间更长(P<0.001)、术中出血量较少(P=0.005)、术后住院时间较短(P<0.001)。然而,除伤口感染外,2组患者间其他并发症差异无统计学意义。此外,与ORH组相比,LRH组复发率较低(P=0.030)、生存率较高(P=0.001)。结论 LRH是一种治疗LACC安全的方法,有助于提高生存率。Objective To evaluate the therapeutic value of laparoscopic radical hysterectomy(LRH) versus open radical hysterectomy(ORH) in locally advanced cervical cancer(LACC). Methods Data from 506 patients who underwent LRH or ORH from The First Hospital of Lanzhou University between January 2010 and December 2017 were analyzed. A propensity score matching(PSM) analysis was done with twelve covariates to balance baseline characteristics of included patients. The surgical results, complications, recurrence rate and survival were analyzed by χ^(2), and the Mann-Whitney U test conducted between two groups.Results After PSM was performed, a well-balanced cohort of 212 patients(106 LRH and 106 ORH) was further analyzed. The LRH group had a bigger number of pelvic lymph nodes retrieved(P = 0.002), longer operative time(P< 0.001), less intraoperative blood loss(P = 0.005) and shorter postoperative hospital stay(P<0.001) compared with the ORH group. However, no statistical difference in other complications between two groups was found, except for wound infection. In addition, the recurrence rate was lower(P = 0.030) and the survival higher(P = 0.001) in the LRH group compared with the ORH group. Conclusion LRH is a safe procedure and an effective alternative for patients with LACC. It could contribute to improved survival.

关 键 词：局部晚期宫颈癌 腹腔镜子宫根治术 开放式子宫根治术 倾向评分匹配 

分 类 号：R737.[医药卫生—肿瘤]