Lee Chyi-Long, Huang Kuan-Gen, Wu Pei-Ju, Lee Pei-Shan, Yen Chih-Feng
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, and Chang Gung University, Tao-Yuan, Taiwan.
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, and Chang Gung University, Tao-Yuan, Taiwan; Institute of Clinical Medical Sciences, Chang Gung University School of Medicine, Tao-Yuan, Taiwan.
Taiwan J Obstet Gynecol. 2014 Mar;53(1):57-61. doi: 10.1016/j.tjog.2012.03.002.
This study aims to evaluate the long-term safety and efficacy of laparoscopic staging surgery (LSS) for endometrial cancer in Taiwanese women.
This is a longitudinal study of prospectively registered 105 patients who underwent LSS for endometrial cancer between June 1995 and June 2008.
The mean duration of surgery was 186.8 minutes, and the mean intraoperative blood loss was 220.38 mL. The median number of retrieved pelvic lymph nodes was 18. The intraoperative complication rate was 4.8%, including two cases of ureteral injury and one case each of bladder injury, bowel injury, and vascular injury. No patient required conversion to laparotomy. During the median follow-up of 55.3 months, six cases of recurrence (5.7%) and three tumor-related deaths (2.9%) were recorded. The 5-year disease-free survival and the overall survival were 93.39% and 98.05%, respectively.
The study revealed favorable perioperative outcomes and better long-term survival than reported in the Taiwan Cancer Registry, and similar good surgical results to those reported in the Western studies. Therefore, LSS by experienced surgeons for endometrial cancer is a feasible and efficacious alternative to laparotomy.
本研究旨在评估腹腔镜分期手术（LSS）对台湾女性子宫内膜癌患者的长期安全性和疗效。
这是一项纵向研究，前瞻性登记了1995年6月至2008年6月期间接受LSS治疗子宫内膜癌的105例患者。
手术平均时长为186.8分钟，术中平均失血量为220.38毫升。盆腔淋巴结切除中位数为18枚。术中并发症发生率为4.8%，包括2例输尿管损伤、1例膀胱损伤、1例肠损伤和1例血管损伤。无患者需要转为开腹手术。在中位随访55.3个月期间，记录到6例复发（5.7%）和3例肿瘤相关死亡（2.9%）。5年无病生存率和总生存率分别为93.39%和98.05%。
该研究显示围手术期结果良好，长期生存率高于台湾癌症登记处报告的数据，且手术效果与西方研究报告的相似。因此，由经验丰富的外科医生进行的子宫内膜癌LSS是开腹手术可行且有效的替代方案。
