开腹与腹腔镜广泛子宫切除术对宫颈癌患者生活质量的影响

Quality of life in cervical cancer survivors after radical hysterectomy via laparoscopy or laparotomy

目的比较开腹与腹腔镜广泛子宫切除术后宫颈癌患者生活质量的差异。方法选取2017年10月至2018年10月北京协和医院随诊的宫颈癌术后患者,采用欧洲癌症研究机构与治疗组织(EORTC)的生活质量测定量表(QLQ-C30)及宫颈癌特异性附加量表(QLQ-Cx24)对患者的生存质量进行评分。结果共纳入319例宫颈癌患者,262例接受了腹腔镜下广泛子宫切除术,57例接受开腹广泛子宫切除术。其中102例患者报告有泌尿系症状,68例报告有结直肠症状。腹腔镜组与开腹手术组患者的诊断年龄、卵巢保留以及术后辅助放疗情况无明显差异;QLQ-C30评价表得分显示,两组的总体生存质量量表项目得分分别为83.3(0~100)分和95.6(41.7~100)分,差异无统计学意义(P=0.931)。结论开腹广泛子宫切除术与腹腔镜下广泛子宫切除术后患者的远期生活质量相近。

Objective To study the difference between laparoscopic and open radical surgery in long-term quality of life(QOL)in cervical cancer survivors.Methods The patients with cervical cancer who were followed up in the Outpatient Department of Peking Union Medical College Hospital(PUMCH)from October 2017 to October 2018 were selected for life quality assessment by the EORTC questionnaires,QLQ-C30 and QLQ-Cx24.Results A total of 319 patients with primary cervical cancer were included in the study.Of all enrolled patients,262 underwent laparoscopic radical hysterectomy while 57 received laparotomy.All patients completed personal information survey,of which 102 patients reported urinary symptoms and 68 reported colorectal symptoms.There were no significant differences in the age of diagnosis,ovarian retention,and postoperative adjuvant radiotherapy between the laparoscopic and open surgery groups.The QLQ-C30 scores showed that the overall quality of life scale items for the laparoscopic and open group were 83.3(0-100)and 95.6(41.7-100)points,respectively,with no statistically significant difference between the two groups(P=0.931).Conclusion Laparoscopic and laparotomic radical hysterectomy are similar in long-term QOL in cervical cancer survivors.