腹腔镜下广泛子宫切除加淋巴结清扫术治疗子宫恶性肿瘤42例分析

Laparoscopic Radical Hysterectomy and Lymphadenectomy for Malignant Uterine Cancer:Analysis on 42 Cases

目的探讨腹腔镜广泛子宫切除加淋巴结清扫术治疗子宫恶性肿瘤的可行性及临床效果。方法回顾分析2007年3月～2011年12月42例腹腔镜手术与同期46例开腹手术行子宫广泛切除、淋巴结清扫治疗的子宫恶性肿瘤的临床资料,比较2组的术中、术后情况。结果与开腹组相比,腹腔镜组术中出血量少[(303.4±118.2)ml vs.(407.6±120.2)ml,t=-4.094,P=0.000],切除淋巴结多[(27.5±5.1)个vs.(20.6±4.3)个,t=6.881,P=0.000],术后排气早[(1.5±0.5)d vs.(2.1±0.6)d,t=-5.069,P=0.000];2组手术病理分期、手术时间、术后并发症的发生率差异无显著性。结论腹腔镜下治疗子宫恶性肿瘤创伤小,恢复快,是一种安全有效的手术方法。

Objective To explore the efficacy of laparoscopic radical hysterectomy and lymphadenectomy for early-stage malignant uterine tumors.Methods Totally 88 patients with malignant uterine cancers received hysterectomy and lymphadenectomy from March 2007 to December 2011 in our hospital.The patients were divided into laparoscopy group（42 cases） and open surgery group（46 cases） according to the surgical approach.The intra-and post-operative data were compared between the two groups.Results The laparoscopy group showed significantly less intraoperative blood loss,more resected lymph nodes,and shorter postoperative gastrointestinal recovery time than the open surgery group [（303.4±118.2） ml vs.（407.6±120.2） ml,t=-4.094,P=0.000;27.5±5.1 vs.20.6±4.3,t=6.881,P=0.000;（1.5±0.5） d vs.（2.1±0.6） d,t=-5.069,P=0.000].However,no significant difference existed in the postoperative pathological staging,operation time,and rate of postoperative complications between the two groups.Conclusions Laparoscopy is a safe,effective and minimally invasive procedure for malignant uterine cancer.Patients recove quickly after the operation.