腹腔镜子宫颈癌根治术与开腹手术的对比研究

目的:对比分析腹腔镜子宫颈癌根治术与开腹手术的临床疗效及安全性。方法:回顾分析2004年2月至2010年2月46例腹腔镜子宫颈癌根治术患者(腹腔镜组)的临床资料,并随机抽取同期46例开腹手术(开腹组)作为对照组,对比分析两组患者手术时间、术中出血量及输血量、淋巴结数量、术中术后并发症发生率、患者住院时间、术后复发情况等。结果:腹腔镜组手术时间、术中出血量及住院时间少于开腹组,差异有统计学意义(P<0.05);两组淋巴结切除数量差异无统计学意义。腹腔镜组术中发生血管损伤1例,术后并发症(如尿潴留、淋巴囊肿、下肢静脉血栓)发生率为26.09%;开腹组术中发生膀胱损伤、输尿管损伤各1例,术后并发症发生率为32.61%;差异无统计学意义。术后随访16～60个月,2例复发。结论:腹腔镜宫颈癌根治术用于宫颈癌的手术分期与治疗具有分期准确、患者创伤小、术中出血少、术后康复快、并发症少等优点,具有极大的临床应用前景。

The comparative study of laparoscopic and open radical operation for uterine cervical carcinoma

Objective:To compare the clinical efficacy and safety between laparoscopic and open radical operation for uterine cervical carcinoma.Methods:The clinical data of 46 patients(laparoscopic group) of cervical carcinoma who underwent laparoscopic radical operation from Feb.2004 to Feb.2010 and another randomly selected 46 patients(open group)who underwent open radical surgery at the same period were analyzed retrospectively.A comparative study was conducted on the operation duration,intraoperative blood loss,blood transfusion,quantity of lymph nodes,perioperative complication incidence,hospital stay and postoperative recurrence rates between the two groups.Results:The mean operation duration and hospital stay of the laparoscopic group was shorter and the mean blood loss was less than that of the open group,with significant statistical differences(P<0.05);There was no significant difference on the number of lymph nodes resected between the 2 groups;The postoperative complications(eg.urine retention,lymphocele,venous thrombosis in lower limb) incidence of laparoscopic group was 26.09%,with one case of intraoperative blood vessel injury,while that of open group was 32.61%,with one case of bladder injury and one case of ureter injury,and there was no significant difference between the 2 groups;2 cases recurred in 16-60 months follow-up.Conclusions:Laparoscopic radical surgery for staging and treatment of uterine cervical carcinoma has the advantages of definite staging,little trauma and intraoperative blood loss,fast recovery and few complications,and it has bright prospect in clinical application.