Huang Wei, Wang Yina, Yang Fanchun, Luo Ning, Ai Guihai, Wu Yuliang, Cheng Zhongping
Department of Gynecology and Obstetrics, Tenth People's Hospital Affiliated to Tongji University, Yancheng, China.
Department of Gynecology and Obstetrics, Yancheng Third People's Hospital, Yancheng, China.
Gynecol Minim Invasive Ther. 2022 Feb 14;11(1):17-22. doi: 10.4103/GMIT.GMIT_121_20. eCollection 2022 Jan-Mar.
The aim of this study was to compare the lymphovascular space invasion between laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH).
One retrospective study was conducted with 391 patients treated with 242 patients underwent ARH and 149 patients underwent LRH between May 2010 and August 2019. We collected clinicopathological and perioperative outcome from medical records. We adopt Student's -test and Chi-square test was used to compare continuous and categorical variables between LRH and ARH.
Our research found that there was no difference in tumor size, histology, pathology grades, positive lymph nodes, and postoperative complications between LRH and ARH ( > 0.05). The estimated blooding loss (EBL) and length of postoperative hospital stay were less for LRH than ARH (248.12 ml vs. 412.56 ml, < 0.05, and 10.48 days vs. 15.16 days, < 0.05). The mean operative time was longer for LRH than ARH (227.51 min vs. 215.62 min, < 0.05). Significant difference was found in intraoperative complications ( < 0.05). However, LVSI was higher for LRH than ARH (36.8% vs. 19.8%, < 0.05). We discovered that the LVSI was related with International Federation of Obstetrics and Gynecology stage and tumor size.
Compared to ARH, the LRH would be advantageous for early cervical cancer in terms of EBL, length of postoperative hospital stay, and intraoperative complications. The ARH was superior to LRH in operative time. In addition to, LRH was more likely to lead to LVSI. Furthermore, when tumor size or stage was increasing, LRH was easily to generate LVSI. But, we cannot confirm recurrence rate is related to LVSI.
本研究旨在比较腹腔镜根治性子宫切除术(LRH)与腹式根治性子宫切除术(ARH)之间的淋巴管间隙浸润情况。
进行了一项回顾性研究,纳入2010年5月至2019年8月期间接受治疗的391例患者,其中242例行ARH,149例行LRH。我们从病历中收集临床病理和围手术期结果。采用Student's -检验和卡方检验比较LRH和ARH之间的连续变量和分类变量。
我们的研究发现,LRH和ARH在肿瘤大小、组织学、病理分级、阳性淋巴结和术后并发症方面无差异(>0.05)。LRH的估计失血量(EBL)和术后住院时间比ARH少(248.12 ml对412.56 ml,<0.05,以及10.48天对15.16天,<0.05)。LRH的平均手术时间比ARH长(227.51分钟对215.62分钟,<0.05)。术中并发症存在显著差异(<0.05)。然而,LRH的淋巴管间隙浸润(LVSI)高于ARH(36.8%对19.8%,<0.05)。我们发现LVSI与国际妇产科联合会分期和肿瘤大小有关。
与ARH相比,LRH在EBL、术后住院时间和术中并发症方面对早期宫颈癌更具优势。ARH在手术时间方面优于LRH。此外,LRH更易导致LVSI。而且,当肿瘤大小或分期增加时,LRH更容易产生LVSI。但是,我们不能确定复发率与LVSI有关。