加速康复外科联合腹腔镜治疗早期卵巢癌的临床研究

Clinical study of enhanced recovery after surgery combined with laparoscopy in the treatment of early-stage ovarian cancer

目的:评价加速康复外科(ERAS)策略联合腹腔镜治疗在早期卵巢癌全面分期术中的安全性、可行性和有效性。方法:回顾分析2017年1月至2018年6月湖南省肿瘤医院妇瘤科收治的早期卵巢癌患者56例,其中ERAS联合腹腔镜手术组(ERAS组)30例,传统腹腔镜手术组(传统组) 26例。分析比较两组患者的围术期情况。结果:ERAS组与传统组均行满意的卵巢癌全面分期术。两组的手术时间、术中出血量、淋巴结清扫数比较,差异均无统计学意义(P>0.05)。ERAS组患者的术后肛门排气时间、术后化疗间隔时间、出院时间较传统组明显缩短(P<0.05)。ERAS组有7例出现术后淋巴囊肿,传统组中出现2例肠梗阻、1例肺部感染、5例淋巴囊肿。两组的并发症发生率比较,差异无统计学意义(P>0.05)。结论:ERAS联合腹腔镜用于早期卵巢癌全面分期手术,可加快患者术后恢复、缩短术后住院时间和化疗间隔时间,且不增加并发症发生。

Objective: To evaluate the safety,feasibility and effectiveness of enhanced recovery after surgery (ERAS) combined with laparoscopy in the treatment of early-stage ovarian cancer. Methods: In a retrospective case-control study,we analyzed 56 patients with early-stage ovarian cancer admitted to the Department of Gynecology in Hunan Cancer Hospital from Jan.2017 to June 2018.The patients were divided into ERAS group (30 cases,treated with ERAS combined with laparoscopy) and conventional group (26 cases,treated with conventional laparoscopy) according to different treatments.The intraoperative and postoperative datas were compared. Results: Both groups had received satisfactory ovarian cancer comprehensive staging surgery.There were no significant differences in operation time,operative blood loss and dissected lymph node number between two groups ( P >0.05).Compared to conventional group,patients in ERAS group had a significantly shorter days of first flatus,interval time of postoperative chemotherapy and length of hospital stay ( P <0.05).ERAS group had 7 cases of lymphatic cyst.Conventional group had 2 cases of intestinal obstruction,1 case of pulmonary infection and 5 cases of lymphatic cyst.There was no significant difference in the rate of overall complication between two groups ( P >0.05). Conclusion: ERAS combined with laparoscopy for early-stage ovarian cancer comprehensive staging surgery can accelerate postoperative recovery,shorten postoperative hospital stay and chemotherapy interval,and do not increase the incidence of complications.