腹腔镜手术与开腹手术治疗子宫颈癌的对比研究
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摘要
目的:探讨腹腔镜下广泛子宫切除(LRH)和盆腹腔淋巴结清扫术治疗子宫颈癌的临床疗效及应用价值。方法:收集2007年7月至2010年01月在我科行子宫颈癌根治术的216例Ia2～IIb期子宫颈癌患者的临床资料,根据手术方式分为腹腔镜组和开腹组,统计并分析两组的手术时间、术中出血量、淋巴结切除数、并发症、术后病理、留置尿管时间、胃肠道功能恢复时间、术后补充治疗间隔时间等指标。结果:115例子宫颈癌腹腔镜手术均顺利完成,无中转开腹病例,与101例开腹手术比较显示两组在切除淋巴结数目、术后病理、并发症、留置尿管时间的差异均无统计学意义(P>0.05),但腹腔镜组的手术时间、出血量、术后肛门排气时间、术后并发症及术后补充治疗间隔时间均较开腹组减少,差异有统计学意义(P<0.05)。随访两组均无切口、穿刺口及阴道、外阴肿瘤转移。结论:腹腔镜下广泛子宫切除和盆腔淋巴结清扫术治疗子宫颈癌安全、有效,值得推广。
Objective: To explore the clinical therapeutic effect and applied value of laparoscopic radical hysterectomy(LRH) and pelvic lymphadenectomy in the treatment of cervical cancer. Methods: A retrospective analysis was made on 216 cases with stage Ia2～IIb cervical cancer from July 2007 to January 2010, cases divided into laparoscopic surgery group and laparotomy group. Statistics and analyze and the short-term results such as the operative time, intraoperative blood loss, complication, recovery time of bowel function, pathological result after operation, number of lymph nodes excised, pelvic lymph node metastasis rate, the interval time of adjunctive therapy after surgery. Results: All the operations were successfully performed under laparoscope. There were no significant differences between the two groups concerning about the number of excised lymph nodes, pathological examination after operation, complication in the operation and the time of keeping urinary canal after operation(P>0.05). To compare with laparotomy group, the operative time and the blood loss during operation was less, recovery of bowel function was earlier, the post-operative complications and the interval time of adjunctive therapy after surgery was less in the laparoscopy group. Conclusion: The laparoscopic radical hysterectomy and pelvic lymphadenectomy in the treatment of Ia2～IIb cervical cancer is safe effectually, which may be applicated and generalizationed in treating cervical cancer.
Objective: To explore the clinical therapeutic effect and applied value of laparoscopic radical hysterectomy(LRH) and pelvic lymphadenectomy in the treatment of cervical cancer. Methods: A retrospective analysis was made on 216 cases with stage Ia2～IIb cervical cancer from July 2007 to January 2010, cases divided into laparoscopic surgery group and laparotomy group. Statistics and analyze and the short-term results such as the operative time, intraoperative blood loss, complication, recovery time of bowel function, pathological result after operation, number of lymph nodes excised, pelvic lymph node metastasis rate, the interval time of adjunctive therapy after surgery. Results: All the operations were successfully performed under laparoscope. There were no significant differences between the two groups concerning about the number of excised lymph nodes, pathological examination after operation, complication in the operation and the time of keeping urinary canal after operation(P>0.05). To compare with laparotomy group, the operative time and the blood loss during operation was less, recovery of bowel function was earlier, the post-operative complications and the interval time of adjunctive therapy after surgery was less in the laparoscopy group. Conclusion: The laparoscopic radical hysterectomy and pelvic lymphadenectomy in the treatment of Ia2～IIb cervical cancer is safe effectually, which may be applicated and generalizationed in treating cervical cancer.
引文
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