腹腔镜与开腹手术对早期子宫内膜癌肥胖女性生活质量的影响

The Effects of Laparoscopy and Laparotomy on Life Quality in Obese Women with Early Endometrial Cancer

目的探讨腹腔镜与开腹手术对早期子宫内膜癌肥胖女性的生活质量的影响。方法回顾性选择61例早期子宫内膜癌肥胖患者,根据手术方法的不同分为对照组(30例)与观察组(31例)。对照组采用开腹手术,观察组采用腹腔镜手术。对比2组的手术结局、围术期指标、围术期并发症发生率;术后均随访3年的预后及术后1年生活质量评分。结果对照组患者均完成手术,观察组中1例患者因对下腔静脉造成损伤,中转为开腹手术。观察组的出血量、术后住院时间、排气时间、手术时间均明显低于对照组(P<0.05),2组的淋巴结清扫个数及留置导尿管时间对比无统计学意义(P>0.05)。观察组的围术期并发症发生率明显低于对照组(P<0.05)。术后均随访3年,2组均未发现复发及死亡者。术后1年时,观察组的FACT-G评分明显高于对照组(P<0.05)。结论与开腹手术相比,腹腔镜手术可缩短早期子宫内膜癌肥胖患者的术后恢复时间,降低患者的围术期并发症发生率,提高患者的生活质量。

Objective To investigate the effects of laparoscopy and laparotomy on life quality in obese women with early endometrial cancer.Methods 61 patients with early endometrial cancer obesity were retrospectively selected,who were divided to the control group(30 cases)and the observation group(31 cases)according to different surgical methods.The control group were given open operation,the observation group were given laparoscopic surgery.The surgical outcome,perioperative indicators,and perioperative complications incidence,the prognosis followed up for 3 years,and the life quality score after surgery for 1 year of 2 groups were compared.Results All patients in the control group were all completed the surgery,and 1 patient in the observation group was converted to open surgery due to damage to the inferior vena cava.The blood loss amount,postoperative hospitalization time,exhaust time and operation time in the observation group were significantly lower than those of the control group(P<0.05),the lymph node dissection number and indwelling catheter time in two groups were not statistically significant(P>0.05).The incidence of perioperative complications in the observation group was significantly lower than that of the control group(P<0.05).The patients were followed up for 3 years after surgery,and no recurrence or death was found in either group.The FACT-G score of the observation group was significantly higher than that of the control group after surgery for 1 year(P<0.05).Conclusion Compared with open surgery,laparoscopic surgery could shorten the postoperative recovery time of obese patients with early endometrial cancer,reduce the incidence of perioperative complications and improve the quality of life of patients.