腹腔镜与开腹手术行广泛子宫切除加盆腔淋巴结清除术的临床效果比较

目的 比较腹腔镜与开腹手术行广泛子宫切除加盆腔淋巴结清除术的临床效果。方法 回顾性分析近2年我院经腹腔镜行广泛子宫切除加盆腔淋巴结清除术的26例子宫恶性肿瘤患者(腹腔镜组)的临床资料,随机抽取近4年行开腹同类手术的27例(开腹组)作为对照。结果腹腔镜组平均手术时间为310 min,开腹组为238 min;腹腔镜组平均切除的淋巴结22个,开腹组为16个;腹腔镜组术中平均出血量为756 ml,开腹组为1129 ml,腹腔镜组平均输血量为321 m1,开腹组为746 ml,腹腔镜组平均术后排气时间为37 h,开腹组为62 h;腹腔镜组术后体温恢复正常时间平均为5 d,开腹组为8 d;腹腔镜组平均应用抗生素时间为6 d,开腹组为8 d;以上各项数据两组间比较,差异均有极显著性(P<0.01)。两组在盆腔引流液(分别为321、216 ml)、尿管拔除时间(分别为13、10d)、术后第3天的白细胞计数(分别为11 × 109/L、10 × 109/L)、术后住院日(分别为26、26 d)及住院费用(分别为25 986、22 672元)等方面比较,差异均无显著性(P>0.05)。结论 腹腔镜下广泛子宫切除及盆腔淋巴结清除术可达到开腹手术的彻底性,并具有创伤小、恢复快等优点。

Clinical analysis of radical hysterectomy plus pelvic lymphadenectomy for patients with malignant uterine tumors: laparoscopy versus laparotomy

OBJECTIVE: To compare clinical efficacy of laparoscopy with laparotomy in radical hysterectomy plus pelvic lymphadenectomy for patients with malignant uterine tumors. METHODS: This retrospective study population included two groups: (1) 26 patients underwent laparoscopy-assisted radical hysterectomy plus pelvic lymphadenectomy (group laparoscopy) and (2) 27 patients were treated with radical hysterectomy plus pelvic lymphadenectomy through laparotomy (group laparotomy). The tumor stage in these two groups of patients was matched. Multiple clinical parameters were observed and analyzed statistically. RESULTS: Compared to the patients in group laparotomy, the patients in group laparoscopy had a longer operative time (310 vs 238 min), more pelvic lymph nodes removed (22 vs 16), lower volume of blood loss (756 vs 1129 ml), and transfusion (321 vs 746 ml), a shorter postoperative gastrointestinal function recovery time (37 vs 62 h), a quicker return to normal temperature (5 vs 8 d), and a shorter period to use antibiotics (6 vs 8 d) (P < 0.01) However, there were no significant differences in the volume of pelvic drainage (321 vs 216 ml), urination recovery time (13 vs 10 d), number of WBC found (11 x 10(9)/L vs 10 x 10(9)/L), hospital stay (26 vs 28 d) and cost (25 986 vs 22 672 Yuan) between the two groups (P > 0.05). CONCLUSION: The clinical efficacy of radical hysterectomy plus pelvic lymphadenectomy by laparoscopy for patients with malignant uterine tumor is equal to that through laparotomy.