腹腔镜手术治疗早期子宫内膜癌的临床体会

Clinical analysis of laparoscopic surgery for early-stage endometrial cancer

目的:探讨腹腔镜手术治疗早期子宫内膜癌的可行性及临床效果。方法:回顾分析2008年1月至2010年12月为8例早期子宫内膜癌患者行腹腔镜手术的临床资料,并与同期随机抽取的8例开腹手术进行对比分析。结果:腹腔镜组与经腹组平均手术时间分别为(175.21±12.75)min、(221.32±23.53)min(t=4.87,P<0.01),平均出血量分别为(316.57±28.52)ml、(430.83±35.13)ml(t=7.16,P<0.01),术后肛门排气时间为(35.56±7.17)h、(52.45±5.32)h(t=5.34,P<0.01),住院时间分别为(5.7±2.3)d、(9.1±1.5)d(t=3.51,P<0.01)。两组平均切除淋巴结(18.2±2.5)枚与(17.7±3.1)枚(t=0.37,P>0.05),术后3天平均体温分别为(37.3±0.2)℃与(37.2±0.3)℃(t=0.82,P>0.05);腹腔镜组1例于术后4个月复发。结论:在严格掌握手术指征的前提下,腹腔镜手术治疗早期子宫内膜癌是可行的,腹腔镜手术具有患者创伤小、术后康复快等明显优势,远期疗效尚待进一步观察。

Objective：To evaluate the feasibility and the clinical outcome of laparoscopic surgical treatment of early-stage endometrial cancer.Methods：The clinical data of 8 patients with early stage endometrial cancer treated by laparoscopy from Jan.2008 to Dec.2010 were retrospectively analyzed.They were compared with 8 patients who received laparotomy during the same time.Results：For laparoscopic group and open group,the mean operating time was（175.21±12.75） min vs（221.32±23.53） min（t=4.87,P0.01）,the mean blood loss during the operation was（316.57±28.52） ml vs（430.83±35.13） ml（t=7.16,P0.01）,the intestinal recovery time was（35.56±7.17） h vs（52.45±5.32） h（t=5.34,P0.01）,postoperative hospital stay was（5.7±2.3） d vs（9.1±1.5） d（t=3.51,P0.01）.No statistical difference was found in the number of lymph nodes resected [（18.2±2.5） vs（17.7±3.1）,（t=0.37,P0.05）] and the average of postoperative body temperature for three days [（37.3±0.2） ℃ vs（37.2±0.3） ℃,（t=0.82,P0.05）] between the two groups.Recurrence was found in 1 patient 4 months later in laparoscopic group.Conclusions：On the premise of strictly controlled indication,laparoscopic surgery is feasible for treatment of early-stage endometrial cancer due to its advantages such as less damage and faster recovery,however,the long-term prognosis still needs further studies.