腹腔镜下全面分期手术治疗早期卵巢癌疗效观察

Clinical effect of laparoscopic radical staged surgery in the treatment of early ovarian cancer

目的探讨腹腔镜下全面分期手术治疗早期卵巢癌的临床效果。方法将2008年3月至2012年3月许昌市中医院手术治疗的86例早期卵巢癌患者分为开腹组(n=38)和腹腔镜组(n=48),开腹组患者给予开腹全面分期手术,腹腔镜组患者给予腹腔镜下全面分期手术,比较2组患者的手术情况、住院时间、术后并发症发生率、复发率及5 a生存率。结果 2组患者手术时间、腹主动脉旁淋巴结切除数、子宫切除例数比较差异无统计学意义(P>0.05);腹腔镜组患者术中出血量低于开腹组(P<0.05),盆腔淋巴结切除数多于开腹组(P<0.05);术后腹腔镜组患者肛门排气时间、术毕至下床时间、引流管留置时间及住院时间显著短于开腹组(P<0.05),疼痛视觉模拟评分低于开腹组(P<0.05)。开腹组和腹腔镜组患者术后并发症发生率分别为21.1%(8/38)和14.6%(7/48),2组患者术后并发症发生率比较差异无统计学意义(χ2=0.622,P>0.05)。全部患者术后随访6~86个月。随访期间,开腹组和腹腔镜组患者复发率分别为15.8%(6/38)和16.7%(8/48),2组患者的复发率比较差异无统计学意义(χ2=0.010,P>0.05);开腹组和腹腔镜组患者5 a生存率分别为84.2%(32/38)和83.3%(40/48),2组患者5 a生存率比较差异无统计学意义(χ2=0.436,P>0.05)。结论腹腔镜下全面分期手术治疗早期卵巢癌具有出血少、创伤小、术后恢复快等优点。

Objective To explore the clinical effect of laparoscopic radical staged surgery in the treatment of early ovarian cancer.Methods Eighty-six patients with early ovarian cancer who were operated in Traditional Chinese Medicine Hospital of Xuchang City from March 2008 to March 2012 were selected and divided into laparotomy group(38 cases)and laparoscope group(48 cases).The patients in the laparotomy group received routine laparotomy,while the patients in the laparoscope group received laparoscopic radical staged surgery.The conditions of surgery,hospital stays,the rate of postoperative complications,the recurrence rate and the 5-year survival rate of the patients in the two groups were compared.Results There was no significant difference in the operation time,the number of paraaortic lymph node resection and hysterectomy cases between the two groups(P>0.05).The intraoperative blood loss of patients in the laparoscope group was significantly lower than that in the laparotomy group(P<0.05);the number of pelvic lymph node resection was significantly more than that in the laparotomy group(P<0.05).The anus exhaust time,the postoperative leaving bed time,the indwelling time of the abdominal drainage tube and the length of stay in the laparoscope group were significantly shorter,and the score of visual analogue scale was lower than those in the laparotomy group(P<0.05).The rates of postoperative complications in the laparotomy group and the laparoscope group were 21.1%(8/38)and 14.6%(7/48);there was no significant difference in the rate of postoperative complications between the two groups(χ2=0.622,P>0.05).All the patients were followed up for 6-86 months.At the period of follow-up,the recurrence rate of patients in the laparotomy group and the laparoscope group was 15.8%(6/38)and 16.7%(8/48);there was no significant difference in the recurrence rate between the two groups(χ2=0.010,P>0.05).The 5-year survival rate of patients in the laparotomy group and the laparoscope group was 84.2%(32/38)and 83.3%(40/48),there was no significant difference in the 5-year survival rate between the two groups(χ2=0.436,P>0.05).Conclusion Laparoscopic radical staged surgery for early ovarian cancer has the advantages of less bleeding,less trauma and postoperative fast recovery.