子宫颈癌腹腔镜与开腹下广泛性子宫切除及淋巴结清扫术的对比分析

Compression of laparoscopic and open radical hysterectomy and pelvic lymphadenectomy in treatment of cervical cancer

目的通过对腹腔镜宫颈癌根治术与开腹宫颈癌根治术的比较,研究腹腔镜下广泛全子宫切除术联合盆腔淋巴结切除术治疗子宫颈癌临床价值。方法回顾性分析腹腔镜和开腹手术治疗临床早期子宫颈癌患者的临床资料,比较两组的手术时间、术中出血量、并发症以及术后恢复情况等方面的差异。结果 67例经腹腔镜和70例开腹手术,两组的手术时间、淋巴结切除数及并发症发生率无显著性差异,而腹腔镜组的术中出血量(332.7±262.9)ml,明显少于同期开腹手术者(511.2±395.5)ml。腹腔镜组术后引流量和排气时间均显著低于开腹组。结论腹腔镜下广泛全子宫切除术联合盆腔淋巴结切除术治疗子宫颈癌是安全、可行的,尤其适用于早期病例的治疗,可以作为治疗子宫颈癌的手段之一。

Objectives： To compare laparoscopic total radical hysterectomy and pelvic lymphadenectomy with classic abdominal surgery, and investigate the clinical value of laparoscopic surgery in treatment of early stage cervical cancer. Methods： The outcomes of laparoscopic and laparotomic total radical hysterectomy ~ pelvic lymphadenectomy were evaluated. Operation time, blood loss, surgical complications and postoperative recovery were compared between the two groups. Results： Sixty seven patients with laparoscopic operation and seventy patients with abdominal operation were included in our study. No difference was found in operation time,numbers of lymph nodes and complications between the two groups. The mean blood loss（332.74-262.9）ml in laparoscopic radical hysterectomy group was significantly lower than that in the laparotomy group（511.2~395.5）mI. And the amount of drainage and gastrointestinal recovery time in laparoscopic operation group were much less. Conclusions： Laparoscopic radical hysterectomy ＆ pelvic lymphadenectomy may be a valuable and safe option for treatment of cervical cancer.