早期子宫内膜癌腹腔镜手术的安全性思考

Safety consideration of laparoscopic surgery for early-stage endometrial cancer

近年来,随着微创技术的发展和成熟,腹腔镜和机器人手术在临床上得到了越来越广泛的应用,多项权威指南推荐微创手术为早期子宫内膜癌的标准手术方式。既往多项随机对照研究均证实了腹腔镜手术的有效性和安全性,但子宫颈癌腹腔镜手术路径研究结果显示,早期子宫颈癌患者微创手术的总生存率低于开腹手术,引发了关于腹腔镜手术安全性的广泛争议。本文回顾大量国内外文献,对子宫内膜癌腹腔镜手术的研究进展和安全性展开综述,以期为临床和科研工作提供参考。

In recent years,with the development and maturation of minimally invasive techniques,laparoscopic and robotic surgery has been increasingly used in clinical practice,and several authoritative guidelines recommend minimally invasive surgery as a standard surgical approach for early-stage endometrial cancer.Several previous randomized controlled trials have confirmed the effectiveness and safety of laparoscopic surgery,but the results of the Laparoscopic Approach to Cervical Cancer Trial showed that the overall survival rate of patients with early-stage cervical cancer was lower than that of open surgery,which has triggered extensive controversies on the safety of laparoscopic surgery.Therefore,this article reviews a large amount of domestic and international literatures and presents a review of the research progress and safety of laparoscopic surgery for endometrial cancer,intending to provide a reference for clinical and scientific work.