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子宫内膜癌腹腔镜手术与开腹手术的围手术期及长期结局

Perioperative and long-term outcomes of laparoscopy and laparotomy for endometrial carcinoma.

作者信息

Yin Xianghua, Shi Min, Xu Jianbo, Guo Qinhao, Wu Huan

机构信息

Department of Obstetrics and Gynecology, Clinical Medical College of Yangzhou University 98 W Nantong Rd, Yangzhou 225001, Jiangsu, China.

出版信息

Int J Clin Exp Med. 2015 Oct 15;8(10):19093-9. eCollection 2015.

Abstract

OBJECTIVE

To compare the efficacy and the clinical value of laparoscopic surgery and traditional abdominal surgery for the treatment of endometrial carcinoma. Meanwhile, assessing the value of preoperative MRI in the depth of myometrial invasion of endometrial carcinoma.

METHODS

we retrospectively analyzed 32 patients with endometrial carcinoma who underwent laparoscopic surgery in Department of Obstetrics and Gynecology in the Subei People's Hospital from September 2008 to March 2015, comparing data using the same surgeons' traditional laparotomy cases during the same period. Data collected includes patient demography, intraoperative and postoperative clinical parameters and follow-up data.

RESULT

All laparoscopic and laparotomy surgery were successful. laparoscopic surgery was better than traditional surgery with less blood loss, more early postoperative anal exhaust time, less postoperative hospital stay, and no seriously complications, there were significant differences (all P<0.05). The average operative time, in the laparoscopy group, was a little longer than the laparotomy group with no statistical significance (P>0.05). There were no differences in the two groups in terms of the number of excised lymph nodes and the recurrence and mortality rate (P>0.05). The sensitivity and specificity of the MRI imaging in assessment of deep myometrial invasion of endometrial carcinoma were 89.3% and 96.2%, respectively.

CONCLUSION

Compared to conventional approaches, laparoscopic surgery showed favorable short-term outcomes with comparable survival. People with endometrial cancer can, therefore, be as safely managed using laparoscopy as laparotomy. MRI is of high value in assessing deep myometrial invasion in patients with endometrial carcinoma.

摘要

目的

比较腹腔镜手术与传统开腹手术治疗子宫内膜癌的疗效及临床价值。同时,评估术前MRI在子宫内膜癌肌层浸润深度方面的价值。

方法

回顾性分析2008年9月至2015年3月在苏北人民医院妇产科行腹腔镜手术的32例子宫内膜癌患者,并与同期同一手术医生的传统开腹手术病例进行数据对比。收集的数据包括患者人口统计学资料、术中及术后临床参数和随访数据。

结果

所有腹腔镜手术和开腹手术均成功。腹腔镜手术在减少术中出血量、术后更早排气时间、缩短术后住院时间且无严重并发症方面优于传统手术,差异有统计学意义(均P<0.05)。腹腔镜组平均手术时间比开腹组长一点,但无统计学意义(P>0.05)。两组在切除淋巴结数量、复发率及死亡率方面无差异(P>0.05)。MRI成像评估子宫内膜癌肌层浸润深度的敏感度和特异度分别为89.3%和96.2%。

结论

与传统方法相比,腹腔镜手术显示出良好的短期疗效且生存率相当。因此,子宫内膜癌患者采用腹腔镜手术治疗与开腹手术同样安全。MRI在评估子宫内膜癌患者肌层浸润深度方面具有很高的价值。

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