盆腔淋巴结清扫术治疗Ⅰa期子宫内膜样腺癌的近远期效果

Short-term and long-term effects of pelvic lymphadenectomy in the treatment of stageⅠa endometrioid adenocarcinoma

目的探讨盆腔淋巴结清扫术治疗Ⅰa期子宫内膜样腺癌的近远期效果。方法纳入2014年6月至2017年6月在海南医学院第一附属医院进行治疗的84例Ⅰa期子宫内膜样腺癌患者。根据是否行盆腔淋巴结清扫术将其分为两组,观察组34例行筋膜外全子宫加双附件切除术+盆腔淋巴结清扫术,对照组50例仅行筋膜外全子宫加双附件切除术。比较两组的手术时间、尿管留置时间、住院时长、并发症发生率及术后复发率。结果观察组并发症发生率高于对照组,差异有统计学意义(P<0.05);观察组复发率高于对照组,但差异无统计学意义(P>0.05);观察组患者手术时间、尿管留置时间、住院时间长于对照组,差异有统计学意义(P<0.05)。结论盆腔淋巴结清扫术不能降低Ⅰa期子宫内膜样腺癌患者复发率、改善预后,且会提高术后并发症的风险,可考虑不行淋巴结清扫术。

Objective To investigate the short-term and long-term effects of pelvic lymphadenectomy in the treatment of stageⅠa endometrioid adenocarcinoma.Methods A total of 84 patients who were treated in the First Affiliated Hospital of Hainan Medical University from June 2014 to June 2017 were included.They were divided into two groups according to whether pelvic lymphadenectomy was performed,34 patients of the observation group underwent total extrafcial hysterectomy plus bilateral adnexectom and pelvic lymphadenectomy,50 patients of the control group underwent total hysterectomy plus bilateral adnexectomy.Operation time,indwelling catheter time,hospital stay,incidence of complications and postoperative recurrence rate were compared between the two groups.Results The incidence of complications in observation group was higher than that in control group,and the difference was statistically significant(P<0.05).The recurrence rate of observation group was higher than that of control group,but the difference was not statistically significant(P>0.05).The operation time,indwelling catheter time and hospital stay of patients in the observation group were longer than those in the control group,and the difference were statistically significant(P<0.05).Conclusion Pelvic lymphadenectomy can not reduce the recurrence rate of patients with stageⅠa endometrioid adenocarcinoma or improve the prognosis,and increase the risk of postoperative complications.Therefore,lymphadenectomy should not be considered.