摘要
目的探讨腹腔镜手术治疗子宫内膜癌的临床疗效及对患者预后的影响。方法根据手术方式的不同将148例子宫内膜癌患者分为开腹组和微创组,每组74例,开腹组患者接受开腹手术治疗,微创组患者接受腹腔镜手术治疗。比较两组患者的围手术期指标、炎性反应指标[血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、营养状态指标[血清总蛋白(TP)、白蛋白(ALB)、前白蛋白(PAB)]、生存情况[无进展生存时间(PFS)、总生存时间(OS)]及并发症发生情况。结果微创组患者无中转开腹病例。两组患者的淋巴结清扫数目比较,差异无统计学意义(P﹥0.05);微创组患者的手术时间、术后首次排气时间、术后首次下床时间、置管时间、住院时间均明显短于开腹组,术中出血量明显少于开腹组,差异均有统计学意义(P﹤0.01)。术后,两组患者的血清CRP、TNF-α、IL-6水平均高于本组术前,微创组患者的血清CRP、TNF-α、IL-6水平均低于开腹组,差异均有统计学意义(P﹤0.05)。术后,两组患者的血清TP、ALB、PAB水平均低于本组术前,微创组患者的血清TP、ALB、PAB水平均高于开腹组,差异均有统计学意义(P﹤0.05)。两组患者的PFS、OS比较,差异均无统计学意义(P﹥0.05)。微创组患者的术后并发症总发生率低于开腹组,差异有统计学意义(P﹤0.05)。结论腹腔镜手术治疗子宫内膜癌可达到与开腹手术相同的淋巴结清扫效果及预后效果,但腹腔镜手术的术中出血量更少,手术安全性更高,术后炎性反应更轻、营养状态更理想。
Objective To investigate the clinical efficacy of laparoscopic surgery in the treatment of endometrial cancer and its effect on the prognosis of patients.Method A total of 148 patients with endometrial cancer were divided into laparotomy group and minimally-invasive group according to different surgical methods,with 74 cases in each group.The patients in the laparotomy group received laparotomy,and the patients in the minimally-invasive group received laparoscopic surgery.The perioperative indicators,inflammatory response indicators[serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],and nutritional status indicators[serum total protein(TP),albumin(ALB),prealbumin(PAB)],survival[progression-free survival(PFS),overall survival(OS)]and complications were compared between the two groups.Result There were no cases of conversion to laparotomy in the minimally-invasive group.There was no significant difference in the number of lymph nodes dissected between the two groups(P>0.05).The operation time,the first postoperative exhaust time,the first postoperative ambulation time,the catheter insertion time,and the hospitalization time of the minimally-invasive group were significantly shorter than those of the laparotomy group,and the intraoperative blood loss was significantly less than that of the laparotomy group,and the differences were statistically significant(P<0.01).After the operation,the serum CRP,TNF-α,and IL-6 levels in the two groups were higher than those before the operation,and the levels of above indicators in the minimally-invasive group were lower than those in the laparotomy group,and the differences were statistically significant(P<0.05).After the operation,the serum levels of TP,ALB,and PAB in the two groups were lower than those before the operation,and the levels of above indicators in the minimally-invasive group were higher than those in the laparotomy group,and the differences were statistically significant(P<0.05).There were no significant differences in PFS and OS between the two groups(P>0.05).The total incidence of postoperative complications in the minimally-invasive group was lower than that in the laparotomy group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic surgery for endometrial cancer could achieve equal lymph node dissection effect and prognostic effect as laparoscopic surgery.However,laparoscopic surgery takes the advantage of less intraoperative blood loss,higher surgical safety,less postoperative inflammatory response,and better nutritional condition.
作者
张峰
陈雁南
杨立
李飞燕
靳冬冬
乔琳
ZHANG Feng;CHEN Yannan;YANG Li;LI Feiyan;JIN Dongdong;QIAO Lin(Department of Gynecology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,He’nan,China)
出处
《癌症进展》
2022年第17期1786-1790,共5页
Oncology Progress
关键词
子宫内膜癌
腹腔镜手术
临床疗效
生存情况
炎性反应
营养状态
endometrial cancer
laparoscopic surgery
clinical efficacy
survival
inflammatory response
nutritional status
