分碎术在次全子宫切除术中用于未预料子宫恶性肿瘤病例对照研究

发布时间：2019-04-30 10:20

【摘要】：目的:探讨分碎术用于子宫恶性肿瘤的机率以及对其预后的影响。方法:选取2008年11月至2014年11月以子宫肌瘤为主诊断行腹腔镜或开腹次全子宫切除术的患者1088例,按手术方式将患者分为腹腔镜组(312例)和开腹组(776例)。比较两组发生未预料子宫恶性肿瘤的机率,并分析患者的临床资料和随访其预后。结果:腹腔镜组中有3例(0.96%)未预料子宫恶性肿瘤(肉瘤2例,内膜癌1例);开腹组中有6例(0.77%)未预料子宫恶性肿瘤(肉瘤4例,内膜癌2例)。两组发生未预料子宫恶性肿瘤的机率比较,差异无统计学意义(P=0.502)。腹腔镜组在子宫肉瘤盆腔种植转移率(50%,1/2)及复发率(50%,1/2)方面均高于开腹组(0%,25%)。结论:分碎术在腹腔镜次全子宫切除术中的应用可能有引起未预料子宫恶性肿瘤(尤其是子宫肉瘤)盆腹腔内种植转移及增加术后复发机会的风险,应引起临床医师重视。
[Abstract]:Objective: to study the probability and prognosis of uterine malignant tumor by fragmentation. Methods: from November 2008 to November 2014, 1088 cases of hysteromyoma diagnosed by laparoscopy or subtotal hysterectomy were divided into laparoscopy group (1088 cases) and open group (776 cases). The incidence of unanticipated uterine malignant tumor was compared between the two groups, and the clinical data and prognosis of the patients were analyzed. Results: in the laparoscopy group, 3 cases (0.96%) had unpredicted uterine malignant tumors (2 sarcomas and 1 endometrial carcinoma) and 6 cases (0.77%) had unpredicted uterine malignant tumors (sarcomas in 4 cases and endometrial carcinoma in 2 cases) in the laparotomy group. There was no significant difference in the incidence of unforeseen uterine malignant tumor between the two groups (P = 0.502). The implantation metastasis rate (50%, 1 / 2) and recurrence rate (50%, 1 / 2) in laparoscopy group were higher than those in laparotomy group (0%, 25%). Conclusion: the application of fractionation in laparoscopic subtotal hysterectomy may lead to unexpected metastasis of uterine malignant tumors, especially uterine sarcomas, and increase the chance of recurrence, which should be paid more attention by clinicians.
【作者单位】：中国医科大学附属盛京医院妇产科;
【分类号】：R737.33

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