摘要
目的研究腹腔镜下广泛全子宫切除术、盆腔淋巴结切除术治疗早期子宫恶性肿瘤的应用价值。方法回顾性分析34例经腹腔镜和30例开腹手术治疗的临床Ⅰ～Ⅱ期子宫恶性肿瘤患者的临床资料,比较两组的手术时间、术中出血量、并发症、术后恢复情况及淋巴结切除数目等。结果两组的手术时间、并发症发生率无显著性差异。腹腔镜组的术中出血量为247.13±127.62ml,明显少于同期开腹手术者(904.51±428.37ml,P<0.01)。腹腔镜组淋巴结切除数为23.2±5.8个,多于开腹组淋巴结切除数(16.5±3.8,P<0.01)。术后胃肠功能恢复时间,腹腔镜组为26.4±8.3h,开腹组为54.6±13.5h,两组间有显著性差异(P<0.01)。术后随访11个月两组均未见复发病例。结论腹腔镜下广泛全子宫切除术、盆腔淋巴结切除术获得满意的效果,近期疗效肯定,远期疗效尚需进一步随访分析。
Objective To investigate and analyze the clinical value of minimal invasive surgery with laparoscope for radical hysterectomy and pelvic lympbadenectomy for the treatment of cervical and endometrial carcinomas in early stage. Methods A retrospective analysis was carried out based on the clinical data of 64 patients with FIGO stage Ⅰ--Ⅱ malignant uterine tumor, among them 34 were operated with the aid of laparoscope and 30 were operated with laparotomy for radical hysterectomy and/or pelvic lymphadenectomy. Comparison was done between the two groups on operative time, blood loss, complications and postoperative recovery. Results There was no significant difference in the incidence of complications and operation time between laparoscopic radical hysterectomy and pelvic lympbadenectomy for the treatment of the patients diagnosed with early stage of cervical and endometrial carcinomas compared with those with traditional radical hysterectomy and pelvic lympbadenectomy through laparatomy. Laparoscopic radical hysterectomy and pelvic lymphadenectomy for the treatment of early stage of cervical and endometrial carcinomas resulted in less blood loss （247. 13± 127. 62ml vs 904. 51±428. 37ml, P〈0. 01）, increase in number of lymph nodes excision （23. 2±5. 8 vs 16. 5±3. 8, P〈0. 01） and better postoperative recovery （26. 4±8. 3h vs 54. 6±13. 5h, P〈0.01）. An 11-month follow up showed that there was no recurrence in both groups. Conclusion Radical laparoscopic hysterectomy and pelvic lyrnpbadeneetomy can be used as an alternative method in treating early stage of cervical and endometrial carcinomas. Radical laparoscopic hysterectomy and pelvic lympbadenectomy can be more beneficial for patients diagnosed as early stage of cervical and endometrial carcinomas, with less operative blood loss, and operative complication and better postoperative recovery. A long-term follow-up is necessary to affirm its superiority.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2007年第5期517-519,共3页
Medical Journal of Chinese People's Liberation Army
作者简介
孟元光，医学博士，副主任医师，副教授，硕士生导师。主要从事妇科恶性肿瘤的临床及基础研究
