腹腔镜下治疗早期卵巢癌的临床疗效分析

目的探讨腹腔镜下广泛性子宫切除术治疗早期卵巢癌的疗效以及对患者预后和生命质量的影响。方法回顾性分析2002年1月1日--2013年1月1日在我科行腹腔镜手术的60例早期卵巢癌患者（腹腔镜组）和行开腹广泛性子宫切除术的60例早期卵巢癌患者（开腹组）的临床病理资料，采用自制的质量量表对存活患者进行生命质量调查，比较两组患者的疗效及生命质量调查结果。结果腹腔镜组和开腹组的手术时间分别为（280．1±78．7）min和（221．5±65．9）min，与开腹组相比，腹腔镜组的手术时间明显增加（拄2．17，P〈0．05）；术中出血量分别为（371±107．1）ml和（488±99．5）ml；与开腹组相比，腹腔镜组的出血量明显减少（t=6．38，P〈0．05）；术后肛门排气时间分别为（44．5±7．1）h和（67．2±9．0）h，与开腹组相比，腹腔镜组的肛门排气时间明显缩短（t=10．12。P〈0．05）；而术后并发症发生率两组患者之间无明显差异（t=1．23，P〉0．05）：开腹组与腹腔镜组患者的复发率和病死率、生命质量调查结果比较，差异均无统计学意义（P〉O．05）。结论腹腔镜下广泛性子宫切除术治疗卵巢癌是安全、可行的，远期疗效良好，可以作为卵巢癌手术治疗的选择方式之一。

Clinical Analysis of Laparoscopic Radical Hysterectomy and Lymphadenectomy for Ovarian Cancer

OBJECTIVE To compare intraoperative, pathologic, postoperative outcomes and quality of life of laparoscopic radical hysterectomy （LRH） with abdominal radical hysterectomy （ARH） for patients with early-stage ovarian cancer. METHODS The consecutive cases with ovarian cancer who took surgery from Jan. 1, 2002 to Jan. 1, 2013 were documented, including 60 patients underwent LRH, and 60 patients took ARH as control group. The clinical data of intraoperative, pathologic, postoperative outcomes and quality of life were compared between these two groups. Survival data were estimated using the log-rank test. RESULTS Mean operative time, it was longer for LRH than that for ARH （280.1±78.7） minutes vs. （221.5±65.9） minutes, t=2.17, P〈0.05]. Mean estimated blood loss was less for LRH than that for ARH （371±107.1） ml vs. （488±99.5） ml, t=6.38, P〈0.05]. Mean recovery time of intestines function was less for LRH than that for ARH＋APL（44.5±7.1 ） hours vs. （67.2±9.0） hours, t=10.12, P〈0.05]. There was no significant difference in numbers of the pelvic lymph nodes resected, the extent of parametrial tissue, vaginal cuff, negative margins obtained and complications. The median follow-up was 32 months （range 4 to 105 months）, there was no significant difference in the recurrence rate and mortality rate. There was not significant difference in quality of life between ARH group and LRH group（P〉0.05）. CONCLUSIONS Laparoseopic surgery for ovarian cancer is safe, feasible and better long term effect. Laparoseopic radical hysterectomy is one of the selective methods for treatment of ovarian cancer.