腹腔镜子宫切除术与经腹子宫切除术治疗早期宫颈癌的临床疗效

Clinical effect of laparoscopic hysterectomy and transabdominal hysterectomy in the treatment of early cervical cancer

目的探讨腹腔镜子宫切除术与经腹子宫切除术治疗早期宫颈癌的临床疗效。方法根据手术方式的不同将85例早期宫颈癌患者分为腔镜组(n=55)和开腹组(n=30),腔镜组患者进行腹腔镜子宫切除术,开腹组患者进行经腹子宫切除术。两组患者术后均随访3年,比较两组患者的术中指标、术后恢复情况、并发症发生情况、生存情况,采用癌症治疗功能评价系统中的宫颈癌量表(FACT-Cx)评价两组患者的生活质量。结果腔镜组患者的手术时间明显长于开腹组,术中出血量明显少于开腹组,差异均有统计学意义(P﹤0.01);两组患者的淋巴结清扫数目比较,差异无统计学意义(P﹥0.05)。腔镜组患者术后首次排气时间、首次排便时间、引流管拔除时间、住院时间均短于开腹组(P﹤0.05);两组患者术后抗生素使用时间比较,差异无统计学意义(P﹥0.05)。腔镜组患者的术后并发症总发生率为14.55%,低于开腹组患者的36.67%,差异有统计学意义(P﹤0.05)。两组患者术后1、3年生存率比较,差异均无统计学意义(P﹥0.05)。术后1、3年,腔镜组患者的FACT-Cx评分均高于开腹组(P﹤0.05)。结论腹腔镜子宫切除术与经腹子宫切除术治疗早期宫颈癌的临床疗效相当,但腹腔镜子宫切除术具有术中出血量少、术后恢复快及并发症少等优点,有助于提高患者术后生活质量。

Objective To explore the clinical effect of laparoscopic hysterectomy and transabdominal hysterectomy in the treatment of early cervical cancer.Method 85 patients with early cervical cancer were divided into laparoscopic group(n=55,received laparoscopic hysterectomy)and open group(n=30,received transabdominal hysterectomy)according to surgical methods.Patients in the two groups were followed up for 3 years after operation.The intraoperative indicators,postoperative recovery,complications,survival were compared between the two groups.The quality of life of patients in the two groups were evaluated by functional assessment of cancer therapy-cervix(FACT-Cx).Result The operation time of patients in the laparoscopic group was longer than that of open group,the intraoperative blood loss of patients in the laparoscopic group was less than that of open group,the differences were statistically significant(P<0.01).There was no significant difference in the number of lymph node dissection between the two groups(P>0.05).The first postoperative exhaust time,first defecation time,drainage tube removal time and hospital stay time in the laparoscopic group were shorter than those in the open group(P<0.05).There was no significant difference in the postoperative antibiotic use time between the two groups(P>0.05).The total incidence of postoperative complications in the laparoscopic group was lower than that in the open group(14.55%vs 36.67%,P<0.05).There was no significant difference in postoperative 1-,3-year survival rate between the two groups(P>0.05).The score of FACT-Cx of patients in the laparoscopic group was higher than that of the open group at 1 and 3 years after operation(P<0.05).Conclusion The clinical effect of laparoscopic hysterectomy and transabdominal hysterectomy is comparable in the treatment of early cervical cancer.However,laparoscopic hysterectomy has less intraoperative blood loss,faster postoperative recovery and fewer complications,which is helpful to improve the postoperative quality of life of patients.