腹腔镜与开腹手术治疗子宫内膜癌的疗效比较

Comparison of efficacy between laparoscopy and laparotomy in the treatment of endometrial carcinoma

目的:探讨腹腔镜与传统开腹手术治疗子宫内膜癌的临床效果差异。方法:回顾性分析陕西省人民医院2013年10月至2018年3月114例确诊为子宫内膜癌并以腹腔镜治疗的患者为研究对象(腹腔镜组),以同期62例开腹手术治疗的子宫内膜癌病例为对照组,两组在手术时间、术中出血量、淋巴结清扫个数、术后膀胱功能恢复时间、排气时间、体温恢复时间、住院时间及并发症等各方面指标进行比较。结果:腹腔镜组术中失血量、输血率、术后体温恢复时间、肠道功能恢复时间、膀胱功能恢复时间、术后住院天数及手术并发症发生率显著低于开腹组(P<0.05)。腹腔镜组与开腹组在手术时间、术中清扫淋巴结数目、复发率及总生存率差异无统计学意义。结论:与传统方法相比,腹腔镜手术短期效果良好,生存率相当,在具备丰富的腹腔镜手术经验、完善的腹腔镜设备的条件下,可以广泛应用于子宫内膜癌患者的治疗。

Objective:To compare the efficacy of laparoscopic surgery and traditional laparotomy surgery for the treatment of endometrial carcinoma.Methods:We retrospectively analyzed 114 patients with endometrial carcinoma who underwent laparoscopic surgery in Department of Obstetrics and Gynecology in Shaanxi Provincial People's Hospital from October 2013 to March 2018,comparing data such as operation time,intraoperative blood loss,number of resected pelvic and para-aotic lymph nodes,bladder function recovery time,temperature recovery time,gastrointestinal recovery time,hospitalization time,surgical complications,with the traditional laparotomy 62 cases during the same period.Results:Laparoscopic surgery was better than traditional surgery with less blood loss,more early postoperative bladder function recovery and anal exhaust time,less postoperative hospital stay,and no seriously complications,and there were significant differences (all P <0.05).The average operative time,in the laparoscopy group,was a little shorter than the laparotomy group with no statistical significance ( P >0.05).There were no differences in the two groups in terms of the number of excised lymph nodes and the recurrence and overall survival rate( P >0.05).Conclusion:Compared to conventional approaches,laparoscopic surgery showed favorable short-term outcomes with comparable survival.People with endometrial cancer can,therefore,be as safely managed using laparoscopy with abundant laparoscopic surgery experience and perfect laparoscopic equipment.