Frigerio L, Gallo A, Ghezzi F, Trezzi G, Lussana M, Franchi M
Obstetric Department, Ospedali Riuniti, Bergamo, Italy.
Int J Gynaecol Obstet. 2006 Jun;93(3):209-13. doi: 10.1016/j.ijgo.2006.02.011. Epub 2006 Mar 6.
To see whether laparoscopy provides exact staging and effective treatment of endometrial cancer patients, compared with total abdominal hysterectomy, with shorter hospital stay, prompter recovery, and better quality of life.
This retrospective study identified 110 patients scheduled for surgery for early-stage endometrial cancer. Fifty-five (50%) were treated by laparoscopic-assisted vaginal hysterectomy (LAVH) and 55 (50%) by total abdominal hysterectomy (TAH). All patients underwent pelvic lymphadenectomy. The majority of patients (79%) had stage I disease.
The mean number of lymph nodes removed was 17 for the LAVH group and 18.5 for the TAH group (p = 0.294). Compared with TAH, LAVH required a significantly longer operating time (220 vs. 175 min; p < 0.01); but shorter hospital stay (4 vs. 8.5 days; p < 0.001) and less estimated blood loss (177 cm3 vs. 285 cm3; p = 0.02). Overall, there were fewer post-operative complications in the LAVH group (6 vs. 11 cases; p < 0.001). Three TAH patients (5.4%) had recurrence of disease. No LAVH patients had recurrences and all are currently disease-free.
These findings suggest LAVH gives correct staging of endometrial disease, like TAH, but with fewer complications and a slightly longer operating time.
比较腹腔镜手术与经腹全子宫切除术，观察腹腔镜手术能否为子宫内膜癌患者提供准确分期及有效治疗，同时缩短住院时间、促进康复并提高生活质量。
这项回顾性研究纳入了110例计划接受早期子宫内膜癌手术的患者。55例（50%）接受腹腔镜辅助阴式子宫切除术（LAVH），55例（50%）接受经腹全子宫切除术（TAH）。所有患者均接受盆腔淋巴结清扫术。大多数患者（79%）为Ⅰ期疾病。
LAVH组平均切除淋巴结数为17个，TAH组为18.5个（p = 0.294）。与TAH相比，LAVH手术时间显著更长（220分钟对175分钟；p < 0.01）；但住院时间更短（4天对8.5天；p < 0.001），估计失血量更少（177立方厘米对285立方厘米；p = 0.02）。总体而言，LAVH组术后并发症更少（6例对11例；p < 0.001）。3例TAH患者（5.4%）疾病复发。LAVH组无患者复发，目前均无疾病。
这些发现表明，LAVH与TAH一样能对子宫内膜疾病进行正确分期，但并发症更少，手术时间稍长。
