腹腔镜在早期卵巢癌全面分期手术中的应用价值

摘要

目的 探讨腹腔镜在早期卵巢癌全面分期手术中的应用价值.方法 对2008年5月～2010年12月该院行手术治疗的早期卵巢癌患者64例进行回顾性分析,其中腹腔镜组29例,开腹组35例.比较两组手术时间、术中出血量、术后排气时间、术后病率、术后并发症、淋巴结切除数量及住院时间等.结果 手术时间腹腔镜组为(125.35±40.24)min,开腹组为(148.56±58.13)min,P＞0.05;腹腔镜组术中出血量(171.25±115.86)mL,开腹组(356.89±120.34)mL,P＜0.05;腹腔镜组切除淋巴结数量(20.54±3.78)个,开腹组(21.47±2.16)个,P ＞0.05;腹腔镜组住院时间(9.28±3.56)d、术后病率8例(27.6％)、术后排气时间(1.5±0.91)d、无伤口感染,开腹组住院时间(18.56±2.13)d,术后病率27例(77.1％)、术后排气时间(2.7±1.02)d、伤口感染9例(25.7％),相应指标分别比较均P＜0.05;两组术中均未发生脏器损伤；术后并发症腹腔镜组3例(10.3％),开腹组5例(14.3％),P ＞0.05.结论 腹腔镜下早期卵巢癌全面分期手术临床效果满意,且具有手术创伤小、术后恢复快的优点.%[ Objective ] To explore the value of comprehensive staging operation for early ovarian cancer under laparoscope. [ Methods ] The outcomes of 64 patients with early ovarian cancer who underwent laparoscope (n=29) or laparotomy (n=35) surgical staging at Shihezi University First Hospital from May 2008 to December 2010 were retrospectively evaluated. The parameters including operation time, intraoperative blood loss, number of resected lymph nodes, postoperative morbidity, gastrointestinal recovery time, postoperative complications and hospital stay were compared between the two groups. [Result] The operation time was 125.35 min ± 40.24 min for the la-paroscopy group and 148.56 ±58.13 min for the laparotomy group (P ＜0.05). The intraoperative blood loss was 171.25±115.86 for the laparoscopy group and 356.89+120.34 for the laparotomy group (P ＜0.05). The number of pelvic lymphnode resected was 20.54±3.78 and 21.47±2.16 for the laparoscopy group and laparotomy group, respectively (P ＞0.05). Compared with the laparotomy group, the laparoscopy group had short hospital stay [(9.28 ± 3.56) d vs. (18.56 ± 2.13) d, P ＜0.05], less postoperative morbidity [8 case (27.6%) vs. 27 case (77.1%), P ＜0.05], shorter gastrointestinal recovery time [(1.5±0.91) d vs. (2.7±1.02) d, P ＜0.05] and less wound infection rate [0 case (0.0%) vs. 9 case (25.7%), P ＜0.05]. No significant difference was found in postoperative complications [3 case (10.3%) vs. 5 case (14.3%)] between the two groups (P ＞0.05). [Conclusion] Compared with laparotomy, comprehensive staging operation for early ovarian cancer under laparoscope can achieve the same therapeutic effect, has advantages of minor trauma, fast postoperative recovery, so it is feasible and safe for early ovarian cancer.