Ⅰb和Ⅰc期子宫内膜癌不同手术范围对患者预后的影响

Influence of the Different Surgical Range on Prognosis of Patients with Ⅰb and Ⅰc Endometrial Cancer

目的探讨Ⅰb和Ⅰc期子宫内膜癌患者不同手术范围对患者预后的影响,为Ⅰb和Ⅰc期子宫内膜癌患者选择手术方式提供参考。方法随访58例子宫次广泛切除、双附件切除及盆腔淋巴结清扫患者(A组)和44例筋膜外全子宫切除、双附件切除及盆腔淋巴结取样患者(B组),患者术后随访均达3年,分别对两组患者3年生存率、复发率及并发症的发生率进行统计分析。结果 (1)A组与B组患者术后3年生存率及复发率比较,差异均无统计学意义(P>0.05);(2)A组与B组患者术后并发症发生率比较,差异有统计学意义(P<0.01)。结论 (1)Ⅰb和Ⅰc期子宫内膜癌并发症的发生率与手术范围有关。(2)Ⅰb和Ⅰc期子宫内膜癌行筋膜外全子宫切除、双附件切除及盆腔淋巴结取样术手术范围已够大,扩大手术范围并不能提高患者的生存率及降低复发率。

Objective To explore the influence of the different surgical range on prognosis of patients with I b and I c endometrial cancer and to provide operation reference for patients with I b and I c endometrial cancer. Methods 58 patients with extended hysterectomy, bilateral salpingooophorectomy and lymphadenectomy （ Group A） and 44 patients with extrafascial total hysterectomy, bilateral salpingooophorectomy and lymph sampling were followed up by telephone and outpatient service. The follow - up lasted three years, in which the survival rate, recurrence rate and incidence of complications were analyzed. Results （ 1 ） There were no significant differences between the two groups in survival rate and recurrence rate three years after operation （P 〉 0. 05）. （2） There were significant differences between the two groups in the incidence of complications after operation （ P 〈 0. 01 ）. Conclusion （ 1 ） The incidence of complications is positively correlated with the extent of the operation ; （2） The scope of extrafascial total hysterectomy, two annexes surgical excision and lymph node biopsy in I b and I c period endometrial carcinoma is large enough, expanding the scope of operation does not improve survival rate and relapse rate, but increases the incidence of complications.