腹腔镜与开腹手术在宫颈癌腹主动脉旁淋巴结清扫术的安全性和生存结局比较

发布时间：2018-05-08 03:25

本文选题：宫颈癌 + 腹腔镜　；参考：《现代妇产科进展》2017年10期

【摘要】：目的:探讨腹腔镜与开腹手术在宫颈癌腹主动脉旁淋巴结清扫术的安全性和生存结局比较。方法:回顾分析2015年1月至2016年12月于武汉大学人民医院行腹主动脉旁淋巴结清扫的86例宫颈癌患者的临床资料。其中50例行腹腔镜术(腹腔镜组),36例行开腹术(开腹组)。比较两组患者的手术时间、术中出血量、腹主动脉旁淋巴结清扫数、术中及术后并发症、术后肛门排气时间、总住院时间、预后情况。结果:两组患者的手术时间比较,差异无统计学意义(P0.05)。与开腹组比较,腹腔镜组的术中出血量明显减少,术后肛门排气时间早,术后总住院时间短,淋巴结清扫数多,差异均有统计学意义(P0.05)。两组的术中输尿管损伤、血管损伤、术后淋巴囊肿、尿潴留、肠梗阻、深静脉血栓、呼吸系统感染发生率比较,差异均无统计学意义(P0.05)。开腹组切口液化4例,腹腔镜组无切口液化,差异有统计学意义(P0.05)。腔镜组与开腹组患者的远期临床预后并无明显差异。结论:腹腔镜下腹主动脉旁淋巴结清扫手术用于宫颈癌治疗有较好的安全性,值得临床推广。
[Abstract]:Objective: to evaluate the safety and survival outcome of laparoscopy and laparotomy in cervical carcinoma with para-aortic lymph node dissection. Methods: the clinical data of 86 patients with cervical cancer underwent abdominal aortic lymph node dissection in Renmin Hospital of Wuhan University from January 2015 to December 2016 were retrospectively analyzed. Among them, 50 cases were performed laparoscopy (laparoscopy group, 36 cases open operation). The operative time intraoperative bleeding number of abdominal aortic lymph node dissection intraoperative and postoperative complications anal exhaust time total hospital stay and prognosis were compared between the two groups. Results: there was no significant difference in operation time between the two groups (P 0.05). Compared with the laparotomy group, the intraoperative bleeding volume in the laparoscopic group was significantly reduced, the postoperative anal exhaust time was earlier, the total hospitalization time was shorter, the number of lymph nodes was more than that in the laparoscopy group, and the difference was statistically significant (P 0.05). The incidence of ureteral injury, vascular injury, postoperative lymphocysts, urinary retention, intestinal obstruction, deep vein thrombosis and respiratory system infection were not significantly different between the two groups (P 0.05). There were 4 cases of incision liquefaction in open group and no incision liquefaction in laparoscope group, the difference was statistically significant (P 0.05). There was no significant difference in long-term clinical prognosis between endoscopic group and open group. Conclusion: laparoscopic para-aortic lymph node dissection is safe and worthy of clinical application in the treatment of cervical cancer.
【作者单位】：武汉大学人民医院妇产科;
【分类号】：R737.33

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