Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Am J Obstet Gynecol. 2012 Sep;207(3):195.e1-8. doi: 10.1016/j.ajog.2012.06.081. Epub 2012 Jul 10.
We sought to compare surgical and survival outcomes of laparoscopic radical hysterectomy (LRH) vs open radical hysterectomy (ORH) in elderly patients with early-stage cervical cancer.
A retrospective analysis was performed on elderly patients (≥65 years) who underwent either LRH (n = 99) or ORH (n = 159) due to stage IA2-IIA2 cervical cancer.
One patient (1%) in LRH group required conversion to laparotomy. Operating time (P = .035), estimated blood loss (P = .002), recovery of bowel movement (P < .001), and postoperative hospital stay (P < .001) were significantly shorter or lower in LRH group. Postoperative complications were significantly less frequent in LRH group (P = .026). After the median follow-up time of 45 months, the 5-year disease-free survival (95% vs 93%, P = .350) and overall survival (96% vs 95%, P = .361) did not differ between LRH and ORH groups.
Elderly patients tolerated well both LRH and ORH. LRH was associated with better surgical outcomes compared to ORH without increasing intraoperative complications or decreasing survival.
我们旨在比较腹腔镜根治性子宫切除术（LRH）与开腹根治性子宫切除术（ORH）在早期宫颈癌老年患者中的手术和生存结局。
对因 IA2 期-IIA2 期宫颈癌而行 LRH（n = 99）或 ORH（n = 159）的老年患者（≥65 岁）进行回顾性分析。
LRH 组有 1 例（1%）患者需要转为剖腹手术。LRH 组的手术时间（P =.035）、估计出血量（P =.002）、肠蠕动恢复时间（P <.001）和术后住院时间（P <.001）均显著较短或较少。LRH 组术后并发症的发生率显著较低（P =.026）。在中位随访 45 个月后，LRH 组和 ORH 组的 5 年无病生存率（95%比 93%，P =.350）和总生存率（96%比 95%，P =.361）无差异。
老年患者对 LRH 和 ORH 均耐受良好。与 ORH 相比，LRH 与更好的手术结局相关，而不会增加术中并发症或降低生存率。
