腹腔镜手术和传统开腹手术治疗早期子宫内膜癌的临床疗效比较

Clinical Comparison of Laparoscopic and Traditional Trans-ventral Operation in the Treatment of Early Endometrial Cancer

【目的】探讨腹腔镜手术和传统开腹手术治疗早期子宫内膜癌的手术情况及复发率。【方法】选取2014年4月至2016年4月在本院接受子宫切除手术治疗的子宫内膜癌患者96例，按照患者意愿分为开腹组和腹腔镜组，每组48例，比较两组患者的手术时间、手术出血总量、术后排气时间、住院时间、并发症及复发情况。【结果】腹腔镜组患者手术时间明显短于开腹组；手术失血量少于开腹组，术后排气时间、住院时间短于开腹组，其差异均有统计学意义（P〈0．05）；腹腔镜组术中并发症（膀胱损伤、肠管损伤等）发生率为2．0％（1／48），明显低于开腹组的16．7％（8／48），其差异有统计学意义（P〈0．05）；两组患者术后并发症（静脉血栓、输尿管瘘、切口感染、远处转移等）及复发率比较差异无统计学意义（P〉0．05）。【结论】早期子宫内膜癌患者手术治疗中，腹腔镜手术方式手术时间、出血量、术中并发症等方面均优于传统开腹方式，且两种手术术后并发症及复发率基本相同。

[Objective]To clinically compare of [aparoscopic surgery and traditional trans-ventral surgery in the treatment of early endometria[ cancer. [MethodslA total of 96 patients with endometrial cancer undergoing hysterectomy in our hospital from April 2014 to April 2016 were selected and divided into two groups randomly： the traditional trans-ventral group and the laparoscopic group , with 48 cases in each group. All study subjects were given general anesthesia and routine sterilization. The patients of the traditional trans-ventral group received traditional trans-ventral operation , while the patients of laparoscopic group received laparoseopic surgery. The operation duration , total operative bleeding volume , postoperative exhaustion time , length of hospital stay , complication and recurrence rate after surgery of the two groups were compared and analyzed. [Results]The operation duration of laparoscopie group was（80.67±12.11）rain , while that of the traditional transventral operation was （119.69±18.64）min. The total loss of blood during operation in the laparoscopic group was less than that of traditional trans ventral group. Both the postoperative exhaustion time and length of hospital stay of the laparoscopic group were much shorter than those of the traditional trans ventral group; the difference was statistically significant（ P 〈0.05）.The incidence of intraoperative complications （bladder inju- ry, bowel injury, etc.） in the laparoscopie group was 2.0 % （1/48）, which was significantly lower than that in the traditional trans-ventral surgery group （ 16.7 %, 8/48）. Postoperative complications （ venous thrombosis, ureteral fistula, incision infection, distant metastasis, etc.） and recurrence rate of the two groups showed no significant difference （ P 〉0.05）.[Conclusion]In the treatment of early endometrial cancer , laparoseopic surgery is superior to the traditional trans-ventral surgery in operation duration , total operative bleeding volume , and intraoperative complication rate..The complication after operation and recurrence rate of two operation methods are essentially the same..