腹腔镜与开放手术治疗子宫恶性肿瘤的临床比较与分析

目的比较腹腔镜与开放手术治疗子宫恶性肿瘤的临床疗效,探讨腹腔镜治疗子宫恶性肿瘤的手术技巧和并发症的防治。方法选择60例子宫恶性肿瘤患者行腹腔镜（腹腔镜组,30例）和开放（开放组,30例）根治性全子宫切除术（或改良根治性全子宫切除术）及盆腔淋巴结清扫术。观察2组患者手术时间、术中出血量、切除盆腔淋巴结数量、术后肛门排气时间、术后下床活动时间、住院时间和并发症等情况。结果腹腔镜组手术时间、术中切除盆腔淋巴结和并发症的发生与开放组无差异。腹腔镜组术中出血量显著少于开放组,术后肛门排气时间早于开放组,术后住院时间短于开放组,差异均有统计学意义（均P〈0.05）。结论腹腔镜下根治性全子宫切除术及盆腔淋巴结清扫术,能完全达到开放手术的要求,手术创伤小、恢复快,临床疗效明显优于开放手术,是一种治疗子宫恶性肿瘤的理想方法。

Comparison and Analysis of Laparoscopic and Laparotomic Surgery for Uterine Malignancies

Objective To compare the clinical efficacy of laparoscopic and laparotomic surgery in uterine malignancies,and to investigate the laparoscopic surgical techniques and the prevention and treatment of complications.Methods Sixty patients with uterine malignancies underwent radical hysterectomy and pelvic lymphadenectomy by laparoscopic surgery（n=30,laparoscopy group） and laparotomic surgery（n=30,laparotomy group）.Operation time,blood loss,number of removed pelvic lymph nodes,anal exhaust time,off-bed activity time,hospital stay and complications were observed in all patients.Results There were no significant differences in operation time,the number of removed pelvic lymph nodes and complication rates between the two groups.Compared with laparotomy group,blood loss,postoperative hospital stay and anal exhaust time obviously decreased in laparoscopy group（all P0.05）.Conclusion Laparoscopic radical hysterectomy and pelvic lymphadenectomy are superior to laparotomy for uterine malignancies with the advantages of minimal trauma and rapid recovery.Therefore,laparoscopic surgery is an ideal method for the treatment of uterine malignancies.