不同术式治疗早期宫颈癌的临床疗效分析与安全性评价

    Clinical efficacy analysis and safety evaluation of different surgical methods in the treatment of early cervical cancer

    • 摘要:
      目的: 探讨开腹手术及腹腔镜手术治疗早期宫颈癌的临床疗效及安全性。
      方法: 采用倾向性得分匹配,按1∶1配对平衡组间差异,选取早期子宫颈癌病人82例作为研究对象,其中腹腔镜手术者(腹腔镜组)41例,开腹手术者(开腹组)85例,均行广泛性全子宫切除、盆腔淋巴结清扫和/或腹主动脉旁淋巴结切除术。对比2组病人围术期指标(手术时间、清扫淋巴结数量、淋巴结阳性率、术中出血量、术后排气时间、下床活动时间、引流管留置时间、住院时间、术后并发症)和肿瘤组织中Ki67、P16、P63表达阳性率的情况。
      结果: 腹腔镜组的手术时间、术中出血量、术后排气时间、下床活动时间、引流管留置时间、术后并发症、住院时间与开腹组相比差异均无统计学意义(P > 0.05),淋巴结清扫数量、淋巴结阳性率均高于开腹组(P < 0.05),Ki67、P16、P63表达阳性率与开腹组差异无统计学意义(P > 0.05),术后3年和5年生存率与腹组差异均无统计学意义(P > 0.05)。
      结论: 与开腹手术相比,腹腔镜组治疗早期宫颈癌病人的手术质量评价较好,两组病人在预后因素及术后生存期上无明显差异。

       

      Abstract:
      Objective To investigate the clinical efficacy and safety of laparotomy and laparoscopy in the treatment of early cervical cancer.
      Methods A total of 82 patients with early cervical cancer were selected as the study subjects by using tendency score matching and 1∶1 matching to balance the differences between the groups, including 41 patients undergoing laparoscopic surgery (laparoscopic group) and 85 patients undergoing open surgery (open group), all of whom underwent extensive total hysterectomy, pelvic lymph node dissection and/or para-aortic lymph node resection. The perioperative indexes (operation time, number of lymph nodes dissected, positive rate of lymph nodes, intraoperative blood loss, postoperative exhaust time, time of getting out of bed, time of drainage tube retention, length of hospital stay, postoperative complications) and the positive rate of Ki67, P16, P63 expression in tumor tissues of the two groups were compared.
      Results There were no significant differences in operation time, intraoperative blood loss, postoperative exhaust time, getting out of bed time, drainage tube retention time, postoperative complications and hospital stay between the laparoscopic group and the laparotomy group (P > 0.05). The number of lymph node dissection and the positive rate of lymph node were higher than those in the laparotomy group (P < 0.05). There was no significant difference in the positive rate of Ki67, P16 and P63 expression between the two groups (P > 0.05). There was no significant difference in the 3-year and 5-year survival rates between the two groups (P > 0.05).
      Conclusion Compared with open surgery, laparoscopic treatment for early cervical cancer patients has better surgical quality evaluation, and there is no significant difference in prognostic factors and postoperative survival between the two groups.

       

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