腹腔镜手术联合腹主动脉旁淋巴结清扫术治疗子宫内膜癌的疗效及深肌层浸润影响因素分析  

Efficacy of laparoscopy surgery combined para-aortic lymph node dissection in endometrial cancer and factors influencing deep muscle infiltration

作　　者：李国鑫 周汉虎 陈星 LI Guoxin;ZHOU Hanhu;CHEN Xing(Department of Gynecology,Ankang Central Hospital,Ankang 725000,Shaanxi,China)

机构地区：[1]安康市中心医院妇科,陕西安康725000

出　　处：《癌症进展》2022年第4期393-395,共3页Oncology Progress

摘　　要：目的分析腹腔镜手术联合腹主动脉旁淋巴结清扫术治疗子宫内膜癌(EC)的疗效及深肌层浸润的影响因素。方法将168例EC患者按手术方式不同分为对照组(n=82,开腹手术联合腹主动脉旁淋巴结清扫术)与观察组(n=86,腹腔镜手术联合腹主动脉旁淋巴结清扫术)。比较两组患者围手术期相关指标、并发症发生情况,并采用多元Logistic回归模型分析影响EC深肌层浸润的危险因素。结果观察组患者淋巴结清扫数明显多于对照组,术中出血量明显少于对照组,淋巴结清扫时间明显长于对照组,术后肛门排气时间及住院时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。观察组患者并发症总发生率明显低于对照组,差异有统计学意义(P﹤0.01)。肿瘤最大径≥3 cm、组织学分级为低分化及术前糖类抗原125(CA125)≥35 U/ml均为EC患者深肌层浸润的独立危险因素(P﹤0.01)。结论腹腔镜手术联合腹主动脉旁淋巴结清扫术治疗EC患者疗效显著,可减少术中出血量,降低并发症发生率,促进患者恢复;影响EC患者深肌层浸润的因素较多,通过分析其影响因素可有效评估深肌层浸润发生情况。Objective To analyze the efficacy of laparoscopy surgery combined para-aortic lymph node dissection in the treatment of endometrial cancer(EC)and factors influencing deep muscle infiltration.Method A total of 168 EC patients were divided into the control group(n=82,open surgery+para-aortic lymph node dissection)and observation group(n=86,laparoscopy surgery+para-aortic lymph node dissection).The perioperative indicators and complications were compared between the two groups.Multivariate Logistic regression was used to analyze the risk factors of EC deep muscle infiltration.Result The number of lymph node dissection in the observation group was more than that in the control group,the intraoperative blood loss lower,the time of lymph node dissection longer,the postoperative anal exhaust time and hospital stay shorter than those in the control group(P<0.01).The total incidence of complications in the observation group was lower than that in the control group(P<0.01).Largest tumor diameter≥3 cm,poor differentiation and preoperative carbohydrate antigen 125(CA125)≥35 U/ml were independent risk factors affecting the deep muscle infiltration of EC patients(P<0.01).Conclusion Laparoscopy combined para-aortic lymph node dissection is effective in treating EC patients,which can reduce intraoperative blood loss and incidence of complications,and promote patient recovery.There are many factors affecting the deep muscle infiltration of EC patients,and analyzing factors can effectively assess the incidence of deep muscle infiltration.

关 键 词：腹腔镜 腹主动脉旁淋巴结清扫术 子宫内膜癌 深肌层浸润 

分 类 号：R737.33[医药卫生—肿瘤]