Department of Obstetrics and Gynecology, Inselspital, Bern University Hospital and University of Bern, Effingerstrasse 102, CH 3012, Bern, Switzerland.
Surg Endosc. 2010 Apr;24(4):939-43. doi: 10.1007/s00464-009-0565-5. Epub 2009 Jun 16.
This study aimed to compare the safety and efficacy of laparoscopy and laparotomy in the surgical treatment of early endometrial cancer, especially in obese women.
The results obtained after laparoscopic surgical treatment of early endometrial cancer (International Federation of Gynecology and Obstetrics (FIGO) stage 1 or 2) in patients between 1996 and 2007 were compared with an age- and tumour-matched historical group of patients treated with laparotomy between 1988 and 1996. All the patients underwent hysterectomy, bilateral salpingo-oophorectomy, and pelvic + or - paraaortic lymphadenectomy.
Both groups included 120 patients with a preoperative diagnosis of early endometrial cancer. The postoperative diagnosis was endometrial cancer stage 1 or 2 for 89% of the cases in both groups. The mean operating time was 170 min for the laparotomy group compared with 178 min for the laparoscopy group (nonsignificant difference). The estimated intraoperative blood loss was significantly greater in the laparotomy group, and the hospital stay was significantly shorter in the laparoscopy group.
The results show that early endometrial cancer can be treated effectively by laparoscopy. Because of this study's retrospective design, the results should be interpreted with caution. However, the advantages of this method for obese patients are evident. The age and weight of these patients should not be used as a contraindication for laparoscopy.
本研究旨在比较腹腔镜和剖腹手术治疗早期子宫内膜癌的安全性和疗效，特别是在肥胖女性中。
将 1996 年至 2007 年间接受腹腔镜手术治疗的早期子宫内膜癌（国际妇产科联合会（FIGO）分期 1 期或 2 期）患者的结果与 1988 年至 1996 年间接受剖腹手术治疗的年龄和肿瘤匹配的历史组患者进行比较。所有患者均接受子宫切除术、双侧输卵管卵巢切除术和盆腔+或-腹主动脉旁淋巴结切除术。
两组均包括 120 例术前诊断为早期子宫内膜癌的患者。两组术后诊断均为子宫内膜癌 1 期或 2 期，占 89%。剖腹组的平均手术时间为 170 分钟，腹腔镜组为 178 分钟（无显著性差异）。剖腹组术中估计出血量明显多于腹腔镜组，腹腔镜组住院时间明显短于剖腹组。
结果表明腹腔镜可有效治疗早期子宫内膜癌。由于本研究的回顾性设计，应谨慎解释研究结果。然而，这种方法对肥胖患者的优势显而易见。这些患者的年龄和体重不应作为腹腔镜手术的禁忌症。
