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目的:探究不同手术方式治疗肥胖型子宫内膜癌的疗效及安全性。方法:2010年3月~2015年3月收治的80例子宫内膜癌患者,根据患者的意愿、身体状况、经济状况分为腹腔镜组及开腹组,腹腔镜组45例,开腹组35例。两组患者均行筋膜外全子宫及双侧附件切除术,比较两组患者在手术时间、术中出血量、淋巴结清扫个数、并发症、导尿管留置时间、恢复排气时间、住院时间、炎症因子水平以及术后1年FACT-G评分上的差异。结果:两种不同的手术操作方式在手术时间以及淋巴结清扫个数上无统计学差异;腹腔镜组的术中出血量明显少于开腹手术组,肛门排气时间、导尿管留置时间及住院时间明显短于开腹手术组;腹腔镜组术后并发症的总发生率为8.9%(4/45),显著低于开腹组术后并发症的总发生率17.1%(6/35);腹腔镜组患者机体的炎症反应显著低于开腹组;术后随访一年,腹腔镜组患者生活质量自测评分显著高于开腹组。结论:与常规开腹手术相比腹腔镜手术在术中出血量,住院时间,术后恢复等方面具有明显的优势,可作为肥胖型子宫内膜癌的治疗手段之一。
Objective: To investigate the efficacy and safety of different surgical methods in the treatment of obese endometrial cancer. Methods: From March 2010 to March 2015, 80 patients with endometrial cancer were divided into laparoscopic group and open group according to their willingness, physical condition and economic status. Among 45 patients with laparoscopic group, 35 cases. Two groups of patients underwent extra-fascicular hysterectomy and bilateral accessory resection. The operation time, intraoperative blood loss, number of lymph node dissection, complications, urinary catheter indwelling time, exhaust time, hospitalization Time, levels of inflammatory cytokines and postoperative 1 year FACT-G score differences. Results: There was no significant difference in the operation time and the number of lymph node dissection between the two different surgical procedures. The intraoperative blood loss in laparoscopic group was significantly less than that in laparotomy group, anal exhaust time, urinary catheter indwelling time and The hospitalization time was significantly shorter than that of the laparotomy group. The overall incidence of postoperative complications in the laparoscopic group was 8.9% (4/45), significantly lower than that of the laparotomy group (17.1%, 6/35 ). The inflammatory response in the laparoscopic group was significantly lower than that in the laparotomy group. After one year of follow-up, the self-rated quality of life of the laparoscopic group was significantly higher than that of the laparotomy group. Conclusion: Compared with conventional laparotomy, laparoscopic surgery has obvious advantages in terms of intraoperative blood loss, length of hospital stay and postoperative recovery, which can be used as a treatment for obese endometrial cancer.