不同手术方式治疗肥胖型子宫内膜癌的疗效、安全性对比分析及对机体炎症因子水平的影响

目的:探究不同手术方式治疗肥胖型子宫内膜癌的疗效及安全性.方法:2010年3月~2015年3月收治的80例子宫内膜癌患者,根据患者的意愿、身体状况、经济状况分为腹腔镜组及开腹组,腹腔镜组45例,开腹组35例.两组患者均行筋膜外全子宫及双侧附件切除术,比较两组患者在手术时间、术中出血量、淋巴结清扫个数、并发症、导尿管留置时间、恢复排气时间、住院时间、炎症因子水平以及术后1年FACT-G评分上的差异.结果:两种不同的手术操作方式在手术时间以及淋巴结清扫个数上无统计学差异;腹腔镜组的术中出血量明显少于开腹手术组,肛门排气时间、导尿管留置时间及住院时间明显短于开腹手术组;腹腔镜组术后并发症的总发生率为8.9%(4/45),显著低于开腹组术后并发症的总发生率17.1%(6/35);腹腔镜组患者机体的炎症反应显著低于开腹组;术后随访一年,腹腔镜组患者生活质量自测评分显著高于开腹组.结论:与常规开腹手术相比腹腔镜手术在术中出血量,住院时间,术后恢复等方面具有明显的优势,可作为肥胖型子宫内膜癌的治疗手段之一.

Comparative analysis of clinical effect and security of different surgical methods on obese patients with endometrial cancer and its influence on the level of inflammatory factor

Objective To explore the clinical effect and security of different surgical methods on patients with obese en-dometrial cancer and its influence on the level of inflammatory factor. Methods 80 cases treated in our hospital from March, 2010 to March, 2015 were divided into the celoscope group (45 cases) and laparotomy group (35 cases). Extrafascial hysterecto-my was conducted in both groups, the time of operation, amount of bleeding, the number of lymph node cleaning, complications, catheter indwelling time, restore the exhaust time, length of stay, level of inflammatory factor, and 1 year postoperative FACT-G score were compared in the two groups. Results There was no statistical difference on the number of lymph node cleaning and the time of operation between the two groups; the amount of bleeding and level of inflammatory factor in celoscope group were significantly lower than those of laparotomy group , the catheter indwelling time, restore the exhaust time, length of stay of celo-scope group were obviously less than those of laparotomy group . The total occurrence rate of complications in celoscope group was 8.9% (4/45), which was significantly lower than the laparotomy group (17.1%). One year of postoperative follow up showed that the FACT-G score of celoscope group was significantly higher than that of laparotomy group . Conclusion Compared with conventional laparotomy, celoscope group was of great advantages on the amount of bleeding, complications and length of stay, which could be used as an effective method on the therapy of endometrial cancer.