腹腔镜与开腹手术治疗早期子宫恶性肿瘤的临床对比分析

目的探讨腹腔镜在早期子宫恶性肿瘤手术治疗中的价值。方法回顾性分析宝鸡市中心医院2010年5月至2011年5月经腹腔镜广泛子宫切除加盆腔淋巴结清扫手术(LRH组)治疗的30例早期宫颈癌及子宫内膜癌,与同期35例经腹广泛性子宫切+盆腔淋巴结清扫术(ARH组)治疗的早期宫颈癌及子宫内膜癌患者的临床资料及并发症发生情况进行对比。结果 LRH组与ARH组的手术时间分别为(170.7±20.0)min、(230.8±32.0)min;术中失血量分别为(38.3±12.0)mL、(836.0±200)mL;输血概率分别为20.8%、80.9%;术后肛门排气时间分别为(34.6±12.0)h、(68.4±20.0)h;住院天数分别为(7.4±1.0)d、(12.5±2.0)d;切口感染或脂肪液化分别为4例、8例,两组比较差异均有统计学意义(P<0.05)。而LRH组与ARH组清扫淋巴数量分别为(20±5)个、(18±5)个;子宫旁或阴道切除范围分别为(2.5±1.2)cm、(3±1)cm,两组比较差异无统计学意义(P>0.05)。结论腹腔镜下子宫恶性肿瘤根治术具有微创,术后并发症、失血和输血更少,住院时间缩短,术后生活质量提高等优点。

Comparative Clinical Analysis of Laparoscopy and Open Abdomen Operation as Treatment for Early Phase Uterine Malignancy

Objective To investigate the value of laparoscopic surgery in treating early phase uterine malignancy.Methods Retrospective analysis on the clinical data and complications of 30 cases of early cervical cancer and endometrial cancer in Baoji Central Hospital from May 2010 to May 2011 treated by laparoscopy radical hysterectomy(LRH),and 35 cases of the same period treated by abdominal radical hysterectomy(ARH)were done.Results Clinical data of LRH and ARH group were as follows respectively:operation time(170.7±20.0)min,(230.8±32.0)min;blood loss during operation(38.3±12.0)mL,(836.0±200)mL;blood transfustion rate 20.8%,80.9%;postoperative anal exhaust time(34.6±12.0)h,(68.4±20.0)h;hospitalization time(7.4±1.0)d,(12.5±2.0)d;incision infections or fat liquefaction 4 cases,8 cases;the differences of above indexes between the two groups were of statistical significance(P<0.05).Cleaned lymphatic number of LRH and ARH group were(20±5),(18±5)respectively;peri-uterus or vaginal resection dimension were(2.5±1.2)cm,(3±1)cm,the differences of above two indexes between the two groups were of no statistical significance(P>0.05).Conclusion LRH has the advantages of minimally invasive,less post-operative complications,less blood loss and blood transfusion,shorter hospital stays,and improved postoperative life quality etc..