[1]宋晓晨,李萌,熊光武,等.早期子宫内膜癌腹腔镜与开腹手术的对比研究[J].中国微创外科杂志,2011,11(5):411-414.
　Song Xiaochen,Li Meng,Xiong Guangwu,et al.Comparison of Laparoscopic and Open Surgeries for Earlystage Endometrial Carcinoma[J].Chinese Journal of Minimally Invasive Surgery,2011,11(5):411-414.
点击复制

早期子宫内膜癌腹腔镜与开腹手术的对比研究()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
11
期数:
2011年5期
页码:
411-414
栏目:
出版日期:
2011-05-20

文章信息/Info

Title:
Comparison of Laparoscopic and Open Surgeries for Earlystage Endometrial Carcinoma
作者:
宋晓晨; 李萌; 熊光武; 郭红燕; 张璐芳; 韩劲松; 朱馥丽; 郭文萍
北京大学第三医院妇产科，北京100191
Author(s):
Song Xiaochen;  Li Meng;  Xiong Guangwu;  et al.
Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
关键词:
子宫内膜癌; 腹腔镜手术; 开腹手术
Keywords:
Endometrial cancer; Laparoscopic surgery; Laparotomy
分类号:
R737.33
文献标志码:
A
摘要:
目的探讨早期子宫内膜癌腹腔镜手术的有效性和安全性。方法回顾性分析我院2003年8月～2010年10月79例早期子宫内膜癌分别施行腹腔镜手术（腹腔镜组，n=56）和开腹手术（开腹组，n=23）的临床资料，比较2组手术时间、术中出血量、淋巴结切除数量、术后排气时间、并发症、术后住院时间、术后病率和复发率。结果腹腔镜组术中出血量(157.1±111.2)ml明显少于开腹组(221.7±169.8)ml (t=1.349,P=0.049)。与开腹组比较，腹腔镜组术后肛门排气时间和住院时间明显缩短(t=4.055,P=0.000；t=2.310,P=0.028)。2组手术时间、盆腔淋巴结切除数目、术后并发症、术后病率均无统计学差异(P>0.05)。术后随访至2011年2月，腹腔镜组50例随访4~82个月，平均28.7月，1例24个月复发，1例31个月穿刺部位转移，无死亡病例；开腹组20例随访17~64个月，平均39.0月，1例27个月复发，1例59个月死亡，2组复发率无统计学差异(精确概率法，P=0.493)。结论早期子宫内膜癌腹腔镜手术较开腹手术具有出血少、恢复快等优势，可作为子宫内膜癌手术的又一选择，远期疗效仍有待探索和证实。
Abstract:
ObjectiveTo evaluate the feasibility and safety of laparoscopy for endometrial carcinoma in an early stage.MethodsFrom August 2003 to October 2010, 79 patients with earlystage endometrial carcinoma who underwent laparoscopic (LPS group, n=56) or laparotomic (LPT group, n=23) surgeries were retrospectively analyzed. The operation time, intraoperative blood loss, number of resected pelvic lymph nodes, gastrointestinal recovery time, and postoperative complications, hospital stay, morbidity and recurrence rate were recorded and compared between the two groups. ResultsLPS group showed significantly less intraoperative blood loss,and shorter gastrointestinal recovery time and hospital stay ［(157.1±111.2) ml vs. (221.7±169.8) ml, t=1.349, P=0.049; t=4.055, P=0.000; and t=2.310, P=0.028, respectively］. No significant difference was found in the number of resected pelvic lymph nodes, postoperative complications and morbidity (P>0.05). The patients were followed up until February 2011. The mean followup in the LPS group (50 cases) was 28.7 months (ranged from 4 to 82 months), and that in the LPT group was 39.0 months (ranged from 17 to 64 months). In the LPS group, 1 patient showed recurrence in 24 months, and 1 patient developed metastasis at the puncture site at month 31, but no patient died. In the LPT group, 1 patient showed recurrence in 27 months, and 1 patient died at month 59. No significant difference was found in the recurrent rate between the two groups(P=0.493). ConclusionsCompared with open surery,laparoscopic surgery has the advantages of less blood and quick recovery in the treatment of earlystage endometrial carcinoma. It may be another choice for endometrial carcinoma,but its clinical value needs to be confirmed by longterm research.

参考文献/References:

[1]Jemal A, Siegel R, Ward E, et al. Cancer Statistics 2007. CA Cancer J Clin,2007,57:43-46.
[2]Childers JM, Surwit EA. Combined laparoscopy and vaginal surgery for management of two cases of stage Ⅰ endometrial cancer.Gynecol Oncol,1992,45:46-51.
[3]Ghezzi F, Cromi A, Uccella S. Laparoscopic versus open surgery for endometrial cancer: a minimum 3year followup study. Ann Surg Oncol,2010,17:271-278.
[4]Kalogiannidis I, Lambrechts S, Amant F, et al. Laparoscopy assisted vaginal hysterectomy compared with abdominal hysterectomy in clinical stage Ⅰ endometrial cancer: safety, recurrence, and longterm outcome. Am J Obstet Gynecol,2007,196(3):248.
[5]Magrina JF.Outcomes of laparoscopic treatment of endometrial cancer.Curr Opin Obstet Gynecol,2005,17(4):343-346.
[6]梁志清,徐慧成,熊光武,等.腹腔镜下淋巴结切除治疗妇科恶性肿瘤的临床分析.中华妇产科杂志,2002,11:656-659.
[7]Cho YH, Kim DY, Kim JH, et al. Laparoscopic management of early uterine cancer:10year experience in Asan Medical Center.Gynecol Oncol,2007,106(3):585-590.
[8]Holub Z, Jabor A, Bartos P, et al. Laparoscopic surgery for endometrial cancer:long term results of a multicentric study.Eur J Gynacol Oncol, 2002, 23: 305-310.
[9]李光仪, 尚慧玲.子宫内膜癌的腹腔镜手术治疗.实用妇产科杂,2006,22: 333-334.
[10]Wong CK,Wong YH,Lo LS,et al.Laparoscopy compared with laparotomy for the surgical staging of endometrial carcinoma.J Obstet Gynaecol,2005,31:286-290.
[11]Schneider A.Vaginal cuff recurrence of endometrial cancer treated by laparoscopicassisted vaginal hysterectomy.Gynecol Oncol,2004,94(3):861.
[12]Chu CS, Randall TC, Bandera CA, Rubin SC.Vaginal cuff recurrence of endometrial cancer treated by laparoscopicassisted vaginal hysterectomy.Gynecol Oncol,2003,88(1):62-65.
[13]Barbaros U, Lyibozkurt AC, Gulluoglu M, et al. Endometriotic umbilical port site metastasis after laparoscopy. Am J Obstet Gyneclo, 2005,193 :1761-1763.
[14]Cho YH, Kim DY, Kim JH, et al. Laparoscopic management of early uterine cancer:10year experience in Asian Medical Center.Gynecol Oncol ,2007,106:585-590.
[15]Faught W, Fung FK. Port site recurrences following laparoscopically managed early stage endometrial cancer. Int J Gynecol Cancer,1999(9):256-268.
[16]Lavie O,Cross PA,Beller U.Laparoscopic portsite metastasis of an early stage adenocarcinoma of the cervix with negative lymph nodes.Gynecol Oncol,1999(75):155-157.
[17]Lee BR, Tan BJ, Smith AD. Laparoscopic port site metastases: incidence, risk factors, and potential preventive measure.Urology,2005,65(4):639-644.
[18]Kuoppala T,Tomas E,Heinonen PK.Clinical outcome and complication of laparoscopic surgery compared with traditional surgery in women with endometrial cancer.Arch Gynecol Obstet,2004,270:25-30.
[19]Eisenkop SM.Total laparoscopic hysterectomy with pelvic/aortic lymph node dissection for endometrial cancera consecutive series without case selection and comparison to laparotomy. Gynecol Oncol, 2010,117(2):216-223.
[20]Malzoni M, Tinelli R, Cosentino F, et al. Total laparoscopic hysterectomy versus abdominal hysterectomy with lymph adenectomy for earlystage endometrial cancer:a prospective randomized study.Gynecol Oncol,2009,112(1):126-133.
[21]刘海防,陈旭,刘彦,等.Ⅰ期子宫内膜癌患者腹腔镜手术后中长期随访比较研究.中国微创外科杂志,2009,9(4):299-301

备注/Memo

备注/Memo:
熊光武通讯作者， Email:xionggw@163.com
更新日期/Last Update: 2013-04-18