腹腔镜辅助阴式手术治疗子宫内膜癌的临床疗效及其安全性研究

Clinical Efficacy and Safety of Laparoscopic Assisted Vaginal Surgery for Endometrial Cancer

目的探讨腹腔镜辅助阴式手术治疗子宫内膜癌临床疗效及其安全性。方法以96例子宫内膜癌作为研究对象,根据手术方法的不同分为观察组与对照组各48例,观察组给予腹腔镜辅助阴式手术治疗,对照组给予开腹手术治疗,记录两组疗效与安全性指标。结果所有患者都顺利完成手术,两组手术时间、肛门排气时间对比无显著差异(P <0. 05),观察组的术中出血量、留置导尿时间、术后住院时间显著优于对照组(P <0. 05)。观察组术后7 d的切口感染、尿潴留、肠梗阻、盆腔淋巴囊肿、切口液化等并发症发生率为6. 3%,对照组为25. 0%,观察组低于对照组(P <0. 05)。术前1 d、术后7 d观察组的疼痛评分分别为(3. 93±1. 84)分和(1. 53±1. 01)分,对照组分别为(4. 02±1. 23)分和(3. 10±1. 78)分,术后7 d观察组的疼痛评分低于对照组(P <0. 05)。观察组术后1、2、3年累积生存率分别为97. 9%、91. 7%、70. 8%,对照组分别为85. 4%、66. 7%、50. 0%,观察组的累积生存率都显著高于对照组(P <0. 05)。结论腹腔镜辅助阴式手术治疗子宫内膜癌能减少对于患者的创伤,减少术后并发症的发生,缓解临床疼痛,提高患者的生存率。

Objective To explore the clinical efficacy and safety of laparoscopy assisted vaginal surgery in the treatment of endometrial carcinoma.Methods 96 cases of endometrial carcinoma were selected as the research object,all the cases were divided into the observation group and the control group with 48 cases in each group accorded to the different surgical methods,the observation group was received the treatment of laparoscopic assisted vaginal surgery,the control group was given open surgery,recorded two groups of efficacy and safety index.Results All patients were successfully completed the operation.There were no significant difference compared in operative time and anal exhaust time between the two groups(P<0.05).The intraoperative blood loss,indwelling catheterization time,and postoperative hospital stay were significantly better in the observation group than in the control group(P<0.05).The postoperative 7d of incidences of incision infection,urinary retention,intestinal obstruction,pelvic lymphatic cyst and incision liquefaction in the observation group was 6.3%,while that in the control group was 25.0%.The observation group was lower than that in the control group(P<0.05).The pain scores of the observation group at 1d and 7d after surgery were(3.93±1.84)and(1.53±1.01),respectively.The control group was(4.02±1.23)points and(3.10±1.78)points,respectively.The pain score of the observation group was lower than that of the control group at 7 days after operation(P<0.05).The postoperative 1,2 and 3 years cumulative survival rates in the observation group were 97.9%,91.7%,and 70.8%,respectively,while those in the control group were 85.4%,66.7%and 50.0%.Log-rank test showed that the cumulative survival rate in the observation group were significantly higher than that in the control group(P<0.05).Conclusion The laparoscopic assisted vaginal surgery for endometrial cancer can reduce trauma,reduce postoperative complications,relieve clinical pain and improve the survival rate of patients.