腹腔镜手术治疗早期子宫内膜癌的临床研究

Effect of laparoscopic surgery in early-stage endometrial cancer

目的探讨腹腔镜手术治疗早期子宫内膜癌的临床疗效。方法选择98例接受治疗的子宫内膜癌患者,根据手术方式的不同分为腹腔镜组(n=49)和对照组(n=49)。腹腔镜组行腹腔镜手术,对照组行开腹手术,观察两组患者的术中出血量、淋巴结清扫个数、手术时间、留置导尿管时间、术后排气时间、术后住院时间等。测量手术开始时、手术1 h、手术结束时血液IL-1β水平,以及术前和术后7 d胰岛素样生长因子-1(IGF-1)、癌胚抗原(CEA)水平,统计术后并发症发生情况。结果腹腔镜组术中出血量、留置导尿管时间、术后排气时间、术后住院时间均少于对照组,手术时间长于对照组,差异均有统计学意义(P﹤0.05)。腹腔镜组手术1 h、手术结束时血液IL-1β水平均低于对照组,差异有统计学意义(P﹤0.05)。腹腔镜组术前及术后7 d的IGF-1、CEA水平均低于对照组,差异有统计学意义(P﹤0.05)。腹腔镜组术后并发症发病率(10.20%)低于对照组(26.53%),差异有统计学意义(P﹤0.05)。结论腹腔镜手术治疗子宫内膜癌创伤小,对免疫系统影响小,术后并发症发生率低,值得应用于临床。

Objective To study the clinical efficacy of laparoscopic surgery in the treatment for patients with earlystage endometrial cancer（EC）. Method 98 cases of EC patients were included in the study, and were stratified as laparoscopy group（n=49） or control group（n=49） as per respective surgical procedures, given laparoscopic surgery or open surgery, respectively. The intra- operative blood loss, number of dissected lymph nodes, operative time, and indwelling time of ureteral catheter, postoperative flatus time, and hospital stay of the two groups were analyzed; Besides, the IL-1βlevels at 0 h, 1 h and the end of surgery, and the level of insulin-like growth factor（IGF-1） and cancer embryo antigen（CEA） at 7 d before and after surgery, as well as the postoperative complications were observed. Conclusion The intraoperative blood loss, indwelling time of ureteral catheter, flatus time and hospital stay were shorter, while operative time was longer in laparoscopy group than the control group, with statistically significant difference observed（P〈0.05）. The level of IL-1β in laparoscopy group at 7 d before and after surgery was significantly lower than that of control group（P〈0.05）. The postoperative incidence of complications in laparoscopy group（10.20%） was lower than that of control group（26.53%）, with significant difference observed（P〈0.05）. Conclusion The laparoscopic surgery is a minimally invasive procedure in the treatment of endometrial carcinoma, with little impact on patients＇ immune system, and low incidence of postoperative complications, and is clinically applicable.