St. Luke's-Roosevelt Hospital Center, New York, New York 10019, USA.
J Minim Invasive Gynecol. 2012 Jul-Aug;19(4):434-42. doi: 10.1016/j.jmig.2012.02.006. Epub 2012 Apr 30.
We performed a search of PUBMED and MEDLINE for articles concerning surgical management of early stage endometrial cancer from 1950 to 2011. From the articles collected we extracted data such as estimated blood loss, operating room time, complications, conversion to laparotomy, and length of hospital stay. Forty-seven relevant sources were analyzed. The patients in the laparoscopy group had less blood loss, fewer complications, longer operating room times, and a shorter length of stay. Lymph node count was similar in both groups. Although obesity is not a contraindication to laparoscopy, it does lead to a higher conversion rate. Route of surgical treatment had no impact on recurrence or survival. Robotic surgery has significant advantages over laparotomy, but advantages over laparoscopy are not as distinct. Laparoscopic hysterectomy offers several advantages over laparotomy. These advantages relate to improvements in patient care with comparable clinical outcome. After careful analysis we believe laparoscopy should be the standard of care for surgical management of early stage endometrial cancer.
我们在 PUBMED 和 MEDLINE 上进行了一次检索，以获取自 1950 年至 2011 年有关早期子宫内膜癌手术治疗的文章。从收集到的文章中，我们提取了出血量、手术室时间、并发症、中转开腹以及住院时间等数据。分析了 47 个相关来源。腹腔镜组患者出血量较少，并发症较少，手术时间较长，住院时间较短。两组的淋巴结计数相似。虽然肥胖不是腹腔镜手术的禁忌症，但确实会导致更高的中转率。手术途径对复发或生存没有影响。机器人手术比剖腹手术有显著优势，但与腹腔镜相比优势并不明显。腹腔镜子宫切除术相对于剖腹手术有几个优点。这些优点与患者护理的改善有关，且临床结果相当。经过仔细分析，我们认为腹腔镜手术应该成为早期子宫内膜癌手术治疗的标准。
