Department of Obstetrics and Gynecology, Beijing Chao-yang Hospital Affiliated to Capital Medical University, Gongti South Road, No. 8, Chaoyang District, Beijing, 100020, China.
J Cancer Res Clin Oncol. 2013 Nov;139(11):1853-9. doi: 10.1007/s00432-013-1504-3. Epub 2013 Sep 6.
We compared laparoscopic approach with the conventional laparotomy approach for the treatment of patients with endometrial carcinoma in developing country.
Two hundred and seventy-two patients with endometrial carcinoma were enrolled in a prospective randomized trial and treated with laparoscopic or laparotomy approach.
One hundred and fifty-one patients were treated by laparoscopy, while one hundred and twenty-one patients were treated by laparotomy. The median operative time was 211 min in the laparoscopy group and 231 min in the laparotomy group (P > 0.05). The median blood loss was 86 ml in the laparoscopy group and 419 ml in the laparotomy group (P < 0.05). The median length of hospital stay was 3 days in the laparoscopy group and 6 days in the laparotomy group (P < 0.05). Pelvic lymphadenectomy was performed in all the patients. Para-aortic lymphadenectomy was performed in 15 % of the laparoscopy and 31.4 % of laparotomy group (P < 0.05). The overall survival and 5-year survival rate for the TLH were 94 and 96 % compared with 90.1 and 91 % in the TAH, respectively (P > 0.05).
Laparoscopic surgery is a safe and reliable alternative to laparotomy in the management of endometrial carcinoma patients, with significantly reduced hospital stay and postoperative complications; however, it does not seem to improve the overall survival and 5-year survival rate, although multicenter randomized trials are required to evaluate the overall oncologic outcomes of this procedure.
我们比较了腹腔镜方法与传统剖腹手术方法在发展中国家治疗子宫内膜癌患者的效果。
将 272 例子宫内膜癌患者纳入一项前瞻性随机试验中，并分别采用腹腔镜或剖腹手术方法进行治疗。
151 例患者接受了腹腔镜治疗，121 例患者接受了剖腹手术治疗。腹腔镜组的中位手术时间为 211 分钟，剖腹手术组为 231 分钟（P>0.05）。腹腔镜组的中位出血量为 86 毫升，剖腹手术组为 419 毫升（P<0.05）。腹腔镜组的中位住院时间为 3 天，剖腹手术组为 6 天（P<0.05）。所有患者均进行了盆腔淋巴结切除术，15%的腹腔镜组和 31.4%的剖腹手术组进行了腹主动脉旁淋巴结切除术（P<0.05）。TLH 的总生存率和 5 年生存率分别为 94%和 96%，与 TAH 的 90.1%和 91%相比，差异无统计学意义（P>0.05）。
与剖腹手术相比，腹腔镜手术在治疗子宫内膜癌患者方面是一种安全可靠的选择，可显著缩短住院时间和减少术后并发症；然而，它似乎并不能提高总生存率和 5 年生存率，尽管需要进行多中心随机试验来评估该手术的整体肿瘤学结局。
