早期子宫内膜癌最佳手术方式研究

Study on the Best Surgical Procedure for Early Endometrial Cancer

目的:探讨治疗早期子宫内膜癌最佳的手术方式。方法:选取本院2008年1月-2012年1月收治的确诊为患有Ⅰ～Ⅱ期子宫内膜癌的178例患者,对其治疗资料进行回顾性分析,所有的患者均在初发时就诊,并都进行手术治疗,且在手术前都没有进行过化疗、放疗以及激素等方式治疗。根据国际标准对患者进行分期,根据治疗方式的不同,手术的方式分为3种,一为全子宫切除术,二为次广泛或者广泛性的子宫切除术,三为施行一或二,并且在同期施行盆腔淋巴结的切除术。然后比较各种手术方式的临床效果,总结出最佳的手术方式。结果:对于Ia期的患者行术式1、术式2、术式3在生存率方面比较差异无统计学意义(P>0.05),对于Ⅰb期的患者,术式2、术式3和术式1相比,在5年生存率上明显要高,而术式2和术式3间比较无差异,对于Ⅰc期和Ⅱ期的患者,术式3的3年以及5年的生存率都最高。结论:对于子宫内膜癌应根据临床的分期,选择合适的手术方式,这是保证手术治疗效果以及患者预后的关键。

Objective：To investigate the best surgical approach to the treatment of early stage endometrial cancer. Method：Selecting 178 patients admitted by our hospital from January 2008 to 2012 January and diagnosed as stage Ⅰ-Ⅱ of endometrial cancer and the clinical data of the patients were analyzed retrospectively.All of the patients were staging with international standard,and than received surgery in the incipience with no way of chemotherapy,radiotherapy and hormone therapy before surgery.According to different surgical method,the operations were divided into three types： the first one was total hysterectomy;the second one was subtotal or extensive hysterectomy;the third one was performed in the base of the first or the second one combined with pelvic lymph node resection in the same period.Comparing the clinical effects of various surgical methods and than identified the best surgical procedures for diffirent stage of endometrial cancer. Result：There was no significant difference in three-year survival rate of Ⅰa patients underwent these three surgical procedures（ P〈0.05）.The five-year survival rate of Ⅰb patients underwent surgical procedure of type two and three were significantly higher than that of type one,however,there was no significant difference between type two and three. for Ⅰc and Phase Ⅱ patients,The 3-year and 5-year survival rates of type three were the highest. Conclusion：According to clinical stage of endometrial cancer to choose an appropriate surgical a pproach ,which is the key to ensure the therapeutic effect and the prognosis of surgery.