腹腔镜手术治疗子宫恶性肿瘤的临床效果

Clinical effect of laparoscopic surgery for the treatment of uterine malignant tumors

目的探讨腹腔镜手术治疗早期子宫恶性肿瘤的安全性、彻底性及并发症的发生情况。方法回顾性分析2010年6月～2014年12月湖北省妇幼保健院妇科实施腹腔镜手术的60例宫颈癌患者及46例子宫内膜癌患者的临床资料并将其设为观察组（腹腔镜组），同期实施开腹手术的60例宫颈癌患者及41例子宫内膜癌患者设为对照组（开腹组）。比较两组术中、术后情况及并发症发生情况。结果腹腔镜组有2例中转开腹，中转率为1．89％，腹腔镜组在术中出血量、输血率、淋巴结切除数目、尿管留置时间、术后并发症发生率与开腹组比较，差异均有统计学意义（P〈0．05），但两组手术时间、住院天数及宫旁阴道断端无瘤率比较，差异无统计学意义（P〉0．05）。结论腹腔镜下子宫恶性肿瘤手术具有创伤小、恢复快、并发症少等优势，值得临床推广。

Objective To explore the safety, thoroughness and complications of laparoscopic surgery to treat early uterine malignant tumors. Methods Clinical data of 60 patients with cervical cancer and 46 patients with endometrial carcinoma who underwent laparoscopic surgery from June 2010 to December 2014 in Department of Gynecology of Hubei Maternal and Child Health Hospital were retrospectively reviewed and they were set to be the observation group （laparoscopy group）. At the same time, 60 patients with cervical cancer and 41 patients with endometrial cancer were recruited to he the control group （open surgery group） who were implemented open surgery. Intraoperative and postopera- tive situations and complications between these two groups were analyzed. Results In 106 patients underwent laparoscopic operation, only 2 cases changed to laparotomy, transfer rate was 1.89%. Blood loss, blood transfusion rate, number of dissected pelvic lymph nodes, bladder function recovery time, occurrence of postoperative complications of the laparoscopie group were significantly different from the open surgery group （P 〈 0.05）, while there were no statistically significant difference between two groups in the mean operation time, hospital day and uterine vaginal cuff disease-free rate （P 〉 0.05）. Conclusion Treatment of uterine malignant tumors by laparoscopic surgery has a quick postoperative recovery, with small trauma, lower complication rate and can he widely carried out.