经脐单孔腹腔镜与传统腹腔镜子宫内膜癌分期手术的疗效比较

Comparison of efficacy between transumbilical single-incision laparoscopic and traditional laparoscopic for endometrial cancer staging surgery

目的探讨经脐单孔腹腔镜与传统腹腔镜子宫内膜癌分期手术的疗效。方法根据手术方式的不同将80例子宫内膜癌患者分为对照组(n=37)和观察组(n=43)。两组患者均进行子宫内膜癌分期手术,对照组患者给予传统腹腔镜手术治疗,观察组患者给予经脐单孔腹腔镜手术(SILS)治疗。比较两组患者的手术相关指标、发热率及疼痛程度[视觉模拟评分法(VAS)],采用伤口美容调查问卷表统计两组患者的伤口美容满意度,采用实体瘤疗效评价标准(RECIST)评价两组患者的手术疗效,采用多因素Logistic回归模型分析手术疗效的影响因素。结果观察组患者的手术时间长于对照组,术后排气时间和住院时间均短于对照组,差异均有统计学意义(P﹤0.05)。术后24 h,两组患者的发热率比较,差异无统计学意义(P﹥0.05);术后48 h,两组患者的发热率均低于本组术后24 h,且观察组患者的发热率低于对照组,差异均有统计学意义(P﹤0.05)。术后24 h,观察组患者的VAS评分低于对照组(P﹤0.05);术后48 h,两组患者的VAS评分均低于本组术后24 h,且观察组患者的VAS评分低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的伤口美容满意度明显优于对照组(P﹤0.01),手术有效率高于对照组(P﹤0.05)。多因素Logistic回归分析结果显示,年龄、文化程度、分化程度、国际妇产科联盟(FIGO)分期均是子宫内膜癌患者手术疗效的独立影响因素(P﹤0.05)。结论在子宫内膜癌分期手术中,SILS可以缩短患者的术后排气时间、住院时间,降低术后疼痛,提高伤口美容满意度,且有利于患者术后体温恢复。

Objective To investigate the efficacy of transumbilical single-incision laparoscopic and traditional laparoscopic for endometrial cancer staging surgery.Method A total of 80 patients with endometrial cancer were divided into control group(n=37)and observation group(n=43)according to different surgical methods.Both groups of patients underwent staging surgery for endometrial cancer,the control group was treated with traditional laparoscopic surgery,and the observation group was treated with transumbilical single-incision laparoscopic surgery(SILS).The surgery-related indicators,fever rate,and pain level[visual analogue scale(VAS)]were compared between the two groups.The wound cosmetic questionnaire was used to evaluate the wound cosmetic satisfaction of the two groups.The response evaluation criteria in solid tumor(RECIST)was used to evaluate the surgical efficacy of the two groups.The multivariate Logistic regression model was used to analyze the risk factors for surgical efficacy.Result The operation time of the observation group was longer than that of the control group,the postoperative exhaust time and hospital stay were shorter than those of the control group,and the differences were statistically significant(P0.05).At 48 hours after the surgery,the fever rate of the two groups were lower than those at 24 hours after the surgery,and the fever rate of the observation group was lower than that of the control group,and the differences were statistically significant(P<0.05).At 24 hours after the surgery,the VAS score of the observation group was lower than that of the control group(P<0.05);at 48 hours after the surgery,the VAS scores of the two groups were lower than those at 24 hours after the surgery,and the VAS score of the observation group was lower than that of the control group,and the differences were statistically significant(P<0.05).The wound cosmetic satisfaction of the observation group was better than that of the control group(P<0.01),and the surgical success rate of the observation group was higher than that of the control group(P<0.05).The results of multivariate Logistic regression analysis showed that age,education level,degree of differentiation,and International Federation of Gynecology and Obstetrics(FIGO)stage were independent risk factors for surgical efficacy in patients with endometrial cancer(P<0.05).Conclusion For patients undergoing staging surgery for endometrial cancer,SILS could shorten their postoperative exhaust time and hospital stay,reduce postoperative pain,improve wound cosmetic satisfaction,and facilitate postoperative body temperature recovery.