腹腔镜筋膜外子宫附件全切加前哨淋巴结显影切除治疗中老年子宫内膜癌疗效分析

Laparoscopic extrafascial hysterectomy,bilateral adnexectomy plus laparoscopic indocyanine green fluorescence guided sentinel lymphadenectomy for middle and old aged patients with endometrial carcinoma

目的探讨腹腔镜筋膜外子宫附件全切加前哨淋巴结显影切除治疗中老年子宫内膜癌患者的疗效。方法选取2018年3月至2021年3月在威海市中心医院手术的80例中老年子宫内膜癌患者作为研究对象,其中40例(观察组)采用腹腔镜筋膜外子宫附件全切加前哨淋巴结显影切除治疗,40例(对照组)采用腹腔镜筋膜外子宫附件全切加盆腔淋巴结系统切除治疗。比较两组患者的手术情况、生活质量、并发症和复发率。计量资料的组间比较采用t检验,计数资料的比较采用χ^(2)检验。结果与对照组相比,观察组术中出血量更少(t=2.818,P<0.01),术后排气时间、住院时间更短(t=3.848、3.840,P<0.01)。两组患者术后生活质量评分较术前均明显提高(t=17.624、10.966,P<0.05),且观察组评分较对照组更高(t=7.734,P<0.01)。观察组患者术后并发症的发生率明显低于对照组(χ^(2)=4.501,P<0.05)。结论腹腔镜筋膜外子宫附件全切加前哨淋巴结显影切除治疗中老年子宫内膜癌患者能够改善围手术期指标,减少术后并发症,提高患者生活质量。

Objective To investigate the effect of laparoscopic extrafascial hysterectomy,bilateral adnexectomy plus laparoscopic indocyanine green fluorescence guided sentinel lymphadenectomy for middle and old aged patients with endometrial carcinoma.Methods A total of 80 endometrial carcinoma patients in Weihai Central Hospital during March 2018 and March 2021 were selected as the research objects.40 cases(observation group)were treated with laparoscopic extrafascial hysterectomy,bilateral adnexectomy plus laparoscopic indocyanine green fluorescence guided sentinel lymphadenectomy,and the other 40 cases(control group)were treated with laparoscopic extrafascial hysterectomy,bilateral adnexectomy plus pelvic lymph node system resection.The operation,quality of life,complications and recurrence rates of the two groups were compared between the two groups.Measurement data and count data were compared between groups using t test orχ^(2)test,respectively.Results Compared with the control group,the observation group had less intraoperative bleeding(t=2.818,P<0.01),shorter postoperative exhaust time and hospital stay(t=3.848,3.840;P<0.01).After operation,the quality of life scores of patients in both groups were improved(t=17.624,10.966;P<0.05),and the score in the observation group was higher than that in the control group(t=7.734,P<0.01).The incidence of postoperative complications in the observation group was significantly lower than that in the control group(χ^(2)=4.501,P<0.05).Conclusion Laparoscopic extrafascial hysterectomy,bilateral adnexectomy plus laparoscopic indocyanine green fluorescence guided sentinel lymphadenectomy for patients with endometrial carcinoma can improve perioperative indicators,reduce postoperative complications,and improve patients’life quality.