子宫内膜癌腹腔镜手术32例临床分析

目的探讨腹腔镜手术治疗子宫内膜癌的临床效果。方法回顾性分析北京大学人民医院2004年2月至2008年12月具有完整资料的子宫内膜癌腹腔镜手术32例患者，并与同期开腹手术32例比较，观察两组的围手术期指标和近期疗效。结果腹腔镜组术中出血量（345．31±276．60）ml，切除淋巴结数量（20．53±8．35）个，开腹组术中出血量（568．75±345．62）ml，切除淋巴结数量（30．41±11．17）个，差异均有统计学意义（P〈0．05）。两组手术时间比较，差异无统计学意义（P＝0．375）。腹腔镜组和开腹组肛门排气时间分别为（1．91±0．86）d和（2．91±1．67）d（P〈0．05），平均住院时间分别为（17．22±6．19）d和（21．72±6．84）d（P=0．002），差异均有统计学意义。腹腔镜组淋巴囊肿形成、切口愈合不良等术后并发症发生率明显低于开腹组（P〈0．05）。两组术后无瘤生存率（P=0．629）、总生存率（P=1．000）及复发率（P=0．629）差异均无统计学意义。结论腹腔镜手术术中出血量少、术后并发症少，近期疗效满意，是治疗早期子宫内膜癌较好的手术方式，但其远期治疗效果及长期预后需进一步研究。

Clinical analysis of laparoscopic surgery in the treatment of 32 cases of endometrial cancer

Objective To investigate the clinical outcome of laparoscopic surgery in women with endometrial cancer. Methods 32 patients who received laparoscopic surgery form February 2004 to December 2008 in Peking University People Hospital were retrospectively reviewed and compared with the patients received traditional laparotomy. Results The blood loss （345.31±276.60）ml vs （568.75±345.62） ml （P〈0.05）, and lymph node counts 20.53±8. 35 vs 30. 41±11.17 （P〈0.05） were significantly reduced in the laparoscopic group, but no significant difference in the operative time （P=0. 375）. The time of bowel function recovery （1.91 ± 0. 86） days vs （2.91±1.67） days （P〈0.01）, and hospital stay （17. 22 ± 6.19） days vs （21.72±6.84） days （P=0. 002）, were also significantly reduced in the laparoscopic group. Postoperative complications such as pelvic lymph cyst and poor wound healing were more common in the laparotomy group. The progress- free survival rate, overall survival rate and recurrence rate are similar between the two groups. Conclusions Laparoscopic surgery is a minimally invasive surgery for the early stage endometrial cancer with less blood loss, fewer postoperative complications and long term prognosis of patients need to be studied.