摘要
目的分析开腹手术与腹腔镜手术治疗早期子宫内膜癌(EC)的疗效及预后影响因素。方法回顾性分析2018年2月至2019年1月在菏泽市立医院接受手术治疗的116例早期EC患者的临床资料,按照手术方式不同分为两组,其中开腹组(n=61)采用开腹手术治疗,腹腔镜组(n=55)采用腹腔镜手术治疗,比较两组手术相关指标(手术时间、术中出血量、术后排气时间、术后住院时间、淋巴结清扫数)及疗效;所有患者均随访至2023年9月,采用Kaplan-Meier法计算两组生存率,并分析预后的影响因素。结果腹腔镜组术中出血量少于开腹组[(52±5)ml比(248±13)ml],术后排气时间、术后住院时间短于开腹组[(16.7±2.2)h比(23.1±3.0)h、(9.8±0.8)d比(14.7±1.8)d](均P<0.01)。两组的并发症发生率比较差异无统计学意义(χ^(2)=0.306,P=0.783)。两组的生存率比较差异无统计学意义(χ^(2)=0.069,P=0.792)。单因素分析结果显示,国际妇产科联盟(FIGO)分期Ⅱ期患者的死亡率高于Ⅰ期,肿瘤分化程度低患者的死亡率高于中、高患者(P<0.05);Cox回归模型分析显示,FIGO分期Ⅱ期、分化程度低是影响早期EC患者预后的危险因素(OR=1.072,95%CI 1.026~1.686;OR=1.069,95%CI 1.011~2.644)(P<0.05)。结论早期EC患者采用开腹手术与腹腔镜手术的安全性及5年生存率基本相同,但腹腔镜手术创伤更小、患者术后恢复快。FIGO分期高、肿瘤分化程度低是影响早期EC患者预后的危险因素。
Objective To analyze the efficacy and prognostic factors of open and laparoscopic surgery for early endometrial cancer(EC).Methods A retrospective analysis was conducted on the clinical data of 116 early EC patients who underwent surgical treatment at Heze Municipal Hospital from Feb.2018 to Jan.2019.The patients were divided into two groups according to different surgical methods,with an open surgery group(n=61)receiving open surgery and a laparoscopic group(n=55)receiving laparoscopic surgery.The surgical related indicators(surgical time,intraoperative blood loss,postoperative exhaust time,postoperative hospitalization time,lymph node dissection number)and efficacy were compared between the two groups.All the patients were followed up until Sep.2023,and Kaplan-Meier method was used to calculate the survival rates of both groups,and the influencing factors of prognosis were analyzed.Results The intraoperative blood loss in the laparoscopic group was less than that in the open group[(52±5)ml vs(248±13)ml],and the postoperative exhaust time and hospitalization time were shorter than those in the open group[(16.7±2.2)h vs(23.1±3.0)h,(9.8±0.8)d vs(14.7±1.8)d](all P<0.01).There was no statistically significant difference in the incidence of complications between the two groups(χ^(2)=0.306,P=0.783).There was no statistically significant difference in the survival rate between the two groups(χ^(2)=0.069,P=0.792).The results of univariate analysis showed that the mortality rate of International Federation of Gynecology and Obstetrics(FIGO)stageⅡpatients was higher than that of stageⅠpatients,and the mortality rate of patients with low tumor differentiation was higher than that of patients with medium and high tumor differentiation(P<0.05);Cox regression model analysis showed that FIGO stageⅡand low differentiation were risk factors affecting the prognosis of early EC patients(OR=1.072,95%CI 1.026-1.686;OR=1.069,95%CI 1.011-2.644)(P<0.05).Conclusion The safety and 5-year survival rate of open surgery in early EC patients are basically the same as laparoscopic surgery,but laparoscopic surgery has less trauma and faster postoperative recovery.High FIGO stage and low tumor differentiation are risk factors for the prognosis of patients with early EC.
作者
王丹丹
刘帅
WANG Dandan;LIU Shuai(The Second Ward of Gynecology,Heze Municipal Hospital,Heze 274031,China;Department of Gynecology,Shanxian Haijiya Hospital,Heze 274300,China)
出处
《医学综述》
CAS
2024年第18期2300-2304,共5页
Medical Recapitulate
关键词
子宫内膜癌
开腹手术
腹腔镜手术
疗效
预后
影响因素
Endometrial carcinoma
Open surgery
Laparoscopic surgery
Efficacy
Prognosis
Influencing factors
作者简介
通信作者:王丹丹,Email:rtxy321@163.com。
