经腹膜入路与腹膜外入路腹腔镜手术治疗子宫内膜癌的临床效果对比

Comparison of Clinical Effects of Transperitoneal and Extraperitoneal Laparoscopic Surgery in the Treatment of Endometrial Carcinoma

目的比较经腹膜入路与腹膜外入路腹腔镜手术治疗子宫内膜癌的效果。方法选取2018年1月至2020年10月濮阳市妇幼保健院收治的76例子宫内膜癌患者作为研究对象,依据门诊单双号分为A组(单号)和B组(双号),各38例。A组接受经腹膜入路手术,B组接受经腹膜外入路手术。对比两组围手术期指标(术中出血量、切除淋巴结数、手术时间、引流管拔除时间以及住院时间),对比两组术后并发症(肠粘连、淋巴囊肿、泌尿系统感染)发生情况,对比两组患者随访6个月复发情况。结果B组手术时间、引流管拔除时间、住院时间短于A组,术中出血量少于A组,切除腹主动脉旁淋巴结数多于A组,差异有统计学意义(P<0.05);B组术后并发症总发生率低于A组,差异有统计学意义(P<0.05);两组复发率比较,差异无统计学意义(P>0.05)。结论相较于经腹膜入路腹腔镜手术,经腹膜外入路腹腔镜手术治疗子宫内膜癌可缩短手术时间、引流管拔除时间以及住院时间,减少术中出血量,增加腹主动脉旁淋巴结切除数,且术后并发症少。

Objective To compare the effect of transperitoneal and extraperitoneal laparoscopic surgery in the treatment of endometrial carcinoma.Methods A total of 76 patients with endometrial carcinoma treated in Puyang Maternity and Child Health Hospital from January 2018 to October 2020 were selected as the research subjects.According to the odd or even number of admission list,they were divided into group A(odd number)and group B(even number),with 38 cases in each group.Transperitoneal approach was used in group A and extraperitoneal approach was used in group B.The perioperative indexes(intraoperative blood loss,number of resected lymph nodes,operation time,drainage tube extraction time and hospitalozation time)were compared between the two groups.The postoperative complications(intestinal adhesion,lymphatic cyst and urinary system infection)were recorded and compared in the two groups.Followed up for 6 months,the recurrence of patients in the two groups was recorded and compared.Results Compared with group A,the operation time,drainage tube extraction time and hospitalization time were shorter,the intraoperative blood loss was less,the number of abdominal paraaortic lymph nodes was more in group B,with statistical significant differences(P<0.05).The total incidence of postoperative complications in group B was lower than that in group A,with a statistical significant difference(P<0.05).There was no statistical significant difference in the recurrence rate between the two groups(P>0.05).Conclusion Compared with transperitoneal laparoscopic surgery,extraperitoneal laparoscopic surgery in the treatment of endometrial carcinoma can shorten the operation time,drainage tube extraction time and hospitalization time,reduce the amount of intraoperative blood loss,increase the number of abdominal paraaortic lymph nodes,and reduce postoperative complications.