Objective. To assess the feasibility of laparoscopy in the treatment of early stage endometrial carcinoma and follow up outcomes compared to classic laparotomy. Methods. A retrospective review of 90 consecutive patien...Objective. To assess the feasibility of laparoscopy in the treatment of early stage endometrial carcinoma and follow up outcomes compared to classic laparotomy. Methods. A retrospective review of 90 consecutive patients with endometrial cancer managed between January 1997 and December 2003. Two groups were defined whether they had been treated by laparoscopy (N = 38; LPS group) or by laparotomy (N = 37; LPM group). Nine patients treated by vaginal hysterectomy and 6 cases with stages III- IV were excluded from the study. Results. Both groups were comparable in mean age and mean BMI. Mean operating time was longer for LPS group, 164.9 ± 5.60 (77- 240) vs. 129.97 ± 5.08 (60- 180) min (P < 0.05). Intraoperative complications were seen in 7 patients (18.9% ) from LPM and in 5 cases (13.2% ) in the laparoscopic group. Two patients (5.2% ) initially evaluated by laparoscopy were converted into laparotomy due to an increasing and uncontrollable hypercapnia. There were more post-operative complications in patients managed by laparotomy (14 cases; 38.8% ), than by laparoscopy (7 cases; 18.4% ) (P < 0.05). Blood transfusion was necessary in 4 patients (10.8% ) in LPM group while none was required in LPS group (P < 0.01). Hospital readmission was only recorded in 3 patients treated by laparotomy (6.7% ) (P < 0.05). Hospital stay was longer in LPM group 7.06 ± 0.58 (4- 21) vs LPS 5.04 ± 0.73 (2- 17) days (P < 0.05). With a median follow up of 53.21 ± 4.32 months for LPM (5- 90) and 36.31 ± 2.75 months for LPS (9- 65) there was no significant difference in disease recurrence between the two groups. Conclusion. Laparoscopic staging combined with vaginal hysterectomy appears to be a feasible alternative to classical surgical approach in patients with early stage I or II endometrial carcinoma.展开更多
目的总结一次性包皮环切缝合器、经典式及袖套式包皮环切术的经验,比较三种包皮环切术式的各自特点。方法回顾性分析于2014年7月至2016年7月期间在我院行包皮环切术(应用一次性包皮环切缝合器、经典式及袖套式包皮环切术分别为112例、12...目的总结一次性包皮环切缝合器、经典式及袖套式包皮环切术的经验,比较三种包皮环切术式的各自特点。方法回顾性分析于2014年7月至2016年7月期间在我院行包皮环切术(应用一次性包皮环切缝合器、经典式及袖套式包皮环切术分别为112例、123例及108例)患者的临床资料,比较三种术式手术时间、术中出血量、疼痛评分、术后并发症发生率、阴茎外观满意率等指标。分析三种手术各自特点和经验总结。结果应用一次性包皮环切缝合器、经典式及袖套式包皮环切术手术时间分别为5.6±3.5 min、25.6±6.7 min及34.3±5.4 min(P<0.001),术中出血量分别为2.0±0.7 m L、12.3±5.8 m及4.1±2.3 m L(P<0.001),术后24 h疼痛评分分别为3.1±1.1分、5.4±1.2分及3.5±0.9分(P<0.001),术后并发症发生率分别为9.8%(11/112)、16.3%(20/123)及11.1%(12/108)(P=0.286),术后阴茎外观满意度分别为97.3%(109/112)、85.4%(105/123)及95.4%(103/108)(P=0.001)。以上数据比较,差异均有统计学意义。结论三组手术方式各有优缺点,应用一次性包皮环切缝合器操作简单、手术时间短、术中出血量少、术后阴茎外观满意率高,但费用偏高;而袖套式包皮环切术相对于经典式包皮环切术手术时间稍长,但术中出血量明显减少、术后疼痛评分低且阴茎外观满意度较高,因此,对于青春期男性及成人患者可考虑推荐袖套式包皮环切术。展开更多
文摘Objective. To assess the feasibility of laparoscopy in the treatment of early stage endometrial carcinoma and follow up outcomes compared to classic laparotomy. Methods. A retrospective review of 90 consecutive patients with endometrial cancer managed between January 1997 and December 2003. Two groups were defined whether they had been treated by laparoscopy (N = 38; LPS group) or by laparotomy (N = 37; LPM group). Nine patients treated by vaginal hysterectomy and 6 cases with stages III- IV were excluded from the study. Results. Both groups were comparable in mean age and mean BMI. Mean operating time was longer for LPS group, 164.9 ± 5.60 (77- 240) vs. 129.97 ± 5.08 (60- 180) min (P < 0.05). Intraoperative complications were seen in 7 patients (18.9% ) from LPM and in 5 cases (13.2% ) in the laparoscopic group. Two patients (5.2% ) initially evaluated by laparoscopy were converted into laparotomy due to an increasing and uncontrollable hypercapnia. There were more post-operative complications in patients managed by laparotomy (14 cases; 38.8% ), than by laparoscopy (7 cases; 18.4% ) (P < 0.05). Blood transfusion was necessary in 4 patients (10.8% ) in LPM group while none was required in LPS group (P < 0.01). Hospital readmission was only recorded in 3 patients treated by laparotomy (6.7% ) (P < 0.05). Hospital stay was longer in LPM group 7.06 ± 0.58 (4- 21) vs LPS 5.04 ± 0.73 (2- 17) days (P < 0.05). With a median follow up of 53.21 ± 4.32 months for LPM (5- 90) and 36.31 ± 2.75 months for LPS (9- 65) there was no significant difference in disease recurrence between the two groups. Conclusion. Laparoscopic staging combined with vaginal hysterectomy appears to be a feasible alternative to classical surgical approach in patients with early stage I or II endometrial carcinoma.
文摘目的总结一次性包皮环切缝合器、经典式及袖套式包皮环切术的经验,比较三种包皮环切术式的各自特点。方法回顾性分析于2014年7月至2016年7月期间在我院行包皮环切术(应用一次性包皮环切缝合器、经典式及袖套式包皮环切术分别为112例、123例及108例)患者的临床资料,比较三种术式手术时间、术中出血量、疼痛评分、术后并发症发生率、阴茎外观满意率等指标。分析三种手术各自特点和经验总结。结果应用一次性包皮环切缝合器、经典式及袖套式包皮环切术手术时间分别为5.6±3.5 min、25.6±6.7 min及34.3±5.4 min(P<0.001),术中出血量分别为2.0±0.7 m L、12.3±5.8 m及4.1±2.3 m L(P<0.001),术后24 h疼痛评分分别为3.1±1.1分、5.4±1.2分及3.5±0.9分(P<0.001),术后并发症发生率分别为9.8%(11/112)、16.3%(20/123)及11.1%(12/108)(P=0.286),术后阴茎外观满意度分别为97.3%(109/112)、85.4%(105/123)及95.4%(103/108)(P=0.001)。以上数据比较,差异均有统计学意义。结论三组手术方式各有优缺点,应用一次性包皮环切缝合器操作简单、手术时间短、术中出血量少、术后阴茎外观满意率高,但费用偏高;而袖套式包皮环切术相对于经典式包皮环切术手术时间稍长,但术中出血量明显减少、术后疼痛评分低且阴茎外观满意度较高,因此,对于青春期男性及成人患者可考虑推荐袖套式包皮环切术。