子宫内膜样腺癌的分期。腹腔镜手术与传统手术方法的临床及费用比较。

Staging endometrioid adenocarcinoma. Clinical and financial comparison of laparoscopic and traditional approaches.

作者信息

Hidlebaugh D A, Orr R K

机构信息

Department of Obstetrics and Gynecology, Fallon Clinic, Worcester, Massachusetts, USA.

出版信息

J Reprod Med. 1997 Aug;42(8):482-8.

PMID:9284009

Abstract

OBJECTIVE

To compare laparoscopically assisted surgical staging (LASS) of endometrioid adenocarcinoma with traditional surgical staging by laparotomy.

STUDY DESIGN

A retrospective review of all cases of uterine cancer (n = 108) insured by one health maintenance organization during 1990-1995. During this period, 29 patients underwent successful LASS and were compared to 64 who underwent laparotomy for treatment of surgical stage I endometrioid adenocarcinoma.

RESULTS

LASS was performed successfully in 29 of 32 attempted cases. All patients on whom LASS was attempted were found to have surgical stage I. Laparoscopic pelvic lymphadenectomy was highly successful, with no failures and a mean number of 14 nodes obtained. The overall complication rate was significantly higher for laparotomy than for LASS (28% vs. 7%, P < .001). The average length of stay for laparotomy was significantly higher than for LASS (5.1 vs. 2.3 days, P < .001).

CONCLUSION

LASS for stage I endometrioid adenocarcinoma is an attractive alternative to traditional surgical staging. It causes fewer complications and shortens the hospital stay.

摘要

目的

比较腹腔镜辅助手术分期（LASS）与传统开腹手术分期用于子宫内膜样腺癌的情况。

研究设计

回顾性分析1990年至1995年期间由一家健康维护组织承保的所有子宫癌病例（n = 108）。在此期间，29例患者成功接受了LASS，并与64例接受开腹手术治疗手术分期为I期子宫内膜样腺癌的患者进行比较。

结果

32例尝试LASS的病例中有29例成功实施。所有尝试LASS的患者均被发现处于手术I期。腹腔镜盆腔淋巴结清扫术成功率很高，无一例失败，平均获取淋巴结数量为14个。开腹手术的总体并发症发生率显著高于LASS（28%对7%，P <.001）。开腹手术的平均住院时间显著长于LASS（5.1天对2.3天，P <.001）。