腹腔镜下与开腹广泛子宫切除术治疗子宫恶性肿瘤的临床疗效对比研究

Clinical Analysis of Radical Hysterectomy for Patients with Malignant Uterine Tumors:Laparoscopic versus Laparotomy

目的:研究腹腔镜下广泛子宫切除术在治疗子宫恶性肿瘤中的临床疗效。方法:2008年6月至2012年8月于我院妇科行腹腔镜下广泛性子宫切除术和盆腔淋巴结清扫术(TLRH+LPL)57例(腹腔镜组)及行传统开腹手术的100例(开腹组)确诊为宫颈癌/子宫内膜癌患者的病历资料。比较两组的手术时间、术中出血量、术中清扫盆腔淋巴结数量,术后肛门排气时间、术后导尿管留置时间等手术情况、住院时间以及两组并发症的发生率。结果:腹腔镜组手术时间、术中出血量均显著长于对照组(P<0.01),清扫盆腔淋巴结数量显著多于对照组(P<0.01)。腹腔镜组术后肛门排气时间、术后住院时间明显短于对照组(P<0.01),两组术后导尿管留置时间无显著差异(P>0.05)。腹腔镜组并发症总发生率为14.0%,对照组并发症总发生率为18.0%,两组并发症总发生率差异均无显著性(P>0.05)。结论:腹腔镜下广泛性全子宫切除术和盆腔淋巴结清扫术较开腹手术比较具有创伤小、恢复快,在不增加手术风险的基础上其手术疗效肯定,可在临床上广泛开展应用。

Objective：To compare the clinical efficacy between laparoscopic and laparotomy for patients with malignant uterine tumors.Methods：The clinical data of 100 cases treated with laparotomy （control group） and 57 cases of total laparoscopic radical hysterectomy （TLRH） and pelvic lymphadenectomy（laparoscopic group） who diagnosed with cervical cancer and endometrial cancer were retrospectively analyzed. The two groups were compared in operative time, blood loss, number of pelvic lymph node dissection in surgery, postoperative anal exhaust time, postoperative catheterization time, length of stay, and complications in the two groups the incidence.Results：Laparoscopic operative time in laparoscopic group was significantly longer than that in the control group （P〈0.01） and blood loss in laparoscopic group was significantly more, than that in the control group （P〈0.01） the dissection of pelvic lymph nodes was significantly more than the control group （P〈0.01） in the number. The laparoscopic group anal exhaust time, postoperative hospital stay was significantly shorter than the control group （P〈0.01）, postoperative catheterization time was no significant difference between the two group（P〉0.05）. Complicat18.0%in the control group （P〉0.05）.Conclusion：TLRH＋LPL under laparoscopic has the feature of trauma, quicker recovery than laparotomy, which does not increase the risk of surgery and should be extensively applied in clinic.