腹主动脉旁淋巴结切除术在子宫内膜癌开腹手术治疗中的应用价值

摘要

目的 探讨腹主动脉旁淋巴结清扫在子宫内膜癌开腹手术治疗中的临床意义.方法 选择接受手术治疗并经病理确诊为子宫内膜癌的患者172例,根据术中是否进行腹主动脉旁淋巴结清扫将入选患者分为观察组109例和对照组63例.观察2组患者围手术期相关指标指标.随访3年,观察2组患者的生存、复发情况及并发症的情况.结果 观察组患者手术时间和住院时间长于对照组,差异有统计学意义(P<0.05).观察组和对照组患者的生存率和死亡率差异无统计学意义(P>0.05),观察组患者的复发率低于对照组(P<0.05),其中病理分级为G2和G3期的观察组患者术后复发率显著低于对照组(P<0.05).观察组患者术后发生淋巴囊肿、下肢淋巴水肿和肠梗阻的概率高于对照组,差异有统计学意义(P<0.05).结论 子宫内膜癌手术治疗中行腹主动脉旁淋巴结清扫能有效降低患者术后复发率,但是增加了术后淋巴囊肿和下肢淋巴水肿的发生率,临床推行过程中应充分评估患者的自身情况.%Objective To explore the clinical significance of abdominal aortic lymph node dissection in the treatment of endometrial surgery. Methods 172 patients who underwent surgical treatment and were diagnosed with endometrial carcinoma were divided into the observation group ( n=109 ) and the control group ( n=63 ) according to whether the abdominal aortic lymph node dissection was performed. Observed the perioperative related indicators of the 2 groups. After 3 years of follow-up, ob-served the survival,recurrence and complications of the 2 groups. Results The operation time and length of stay in the observa-tion group were higher than that of the control group,the difference was statistically significant (P<0. 05). The difference of sur-vival rate and mortality in the observation group and the control group was not statistically significant (P<0. 05),the recurrence rate of the observation group was lower than the control group,the difference was statistically significant (P<0. 05). The recur-rence rate of the control group was significantly lower than observation group in the of pathological G2 and G3 grading,there was statistical significant differences (P<0. 05). In the observation group,the probability of postoperative lymphatic cyst,lower ex-tremity lymph edema and intestinal obstruction was higher than that of the control group,the difference was statistically significant (P<0. 05). Conclusion Surgical treatment of endometrial cancer underwent paraaortic lymph node dissection can effectively reduce the recurrence rate of patients after surgery,but increased postoperative lymphatic cyst and lower limb lymphedema inci-dence,we should assess the patient's own situation in the process of implementation in clinical.