过去十年间子宫内膜癌腹腔镜子宫切除术的实施情况。
Implementation of laparoscopic hysterectomy for endometrial cancer over the past decade.
作者信息
Wollinga Tim, Ezendam Nicole P M, Eggink Florine A, Smink Marieke, van Hamont Dennis, Pijlman Brenda, Boss Erik, Robbe Elisabeth J, Ngo Huy, Boll Dorry, Mom Constantijne H, van der Aa Maaike A, Kruitwagen Roy F L P, Nijman Hans W, Pijnenborg Johanna M A
机构信息
1Medical Faculty, Erasmus University, Rotterdam, The Netherlands.
2Department of Obstetrics and Gynecology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.
出版信息
Gynecol Surg. 2018;15(1):7. doi: 10.1186/s10397-018-1040-x. Epub 2018 Feb 27.
BACKGROUND
Laparoscopic hysterectomy (LH) for the treatment of early-stage endometrial carcinoma/cancer (EC) has demonstrated to be safe in several randomized controlled trials. Yet, data on implementation of LH in clinical practice are limited. In the present study, implementation of LH for EC was evaluated in a large oncology network in the Netherlands.
RESULTS
Retrospectively, a total of 556 EC patients with FIGO stage I-II were registered in the selected years. The proportion of LH gradually increased from 11% in 2006 to 85% in 2015. LH was more often performed in patients with low-grade EC and was not related to the studied patient characteristics. The introduction of TLH was frequently preceded by LAVH. Patients treated in teaching hospitals were more likely to undergo a LH compared to patients in non-teaching hospitals. The conversion rate was 7.7%, and the overall complication rates between LH and AH were comparable, but less postoperative complications in LH.
CONCLUSIONS
Implementation of laparoscopic hysterectomy for early-stage EC increased from 11 to 85% in 10 years. Implementation of TLH was often preceded by LAVH and was faster in teaching hospitals.
背景
在多项随机对照试验中，腹腔镜子宫切除术（LH）治疗早期子宫内膜癌（EC）已被证明是安全的。然而，关于LH在临床实践中的应用数据有限。在本研究中，在荷兰的一个大型肿瘤网络中评估了LH用于EC的情况。
结果
回顾性分析，在选定年份共登记了556例国际妇产科联盟（FIGO）分期为I-II期的EC患者。LH的比例从2006年的11%逐渐增加到2015年的85%。低级别EC患者更常接受LH治疗，且与所研究的患者特征无关。全腹腔镜子宫切除术（TLH）的开展之前常有腹腔镜辅助阴式子宫切除术（LAVH）。与非教学医院的患者相比，教学医院的患者更有可能接受LH治疗。转换率为7.7%，LH和开腹子宫切除术（AH）的总体并发症发生率相当，但LH术后并发症较少。
结论
10年间，早期EC的腹腔镜子宫切除术实施率从11%提高到了85%。TLH的开展之前常有LAVH，且在教学医院开展得更快。
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