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目的:评价腹腔镜广泛子宫切除术加双侧盆腔、腹主动脉旁淋巴结清扫术治疗妇科恶性肿瘤患者的应用价值。方法:回顾分析2009年6月至2013年9月为20例子宫内膜癌、宫颈癌患者行腹腔镜手术的临床资料,观察手术时间、术中出血量、切除淋巴结数量、术后肛门排气时间及术后并发症等指标,并与同期开腹手术进行对比分析。结果:20例腹腔镜手术均顺利完成,无一例中转开腹。两组手术时间、术中失血量、术后肛门排气时间、术后下床活动时间、切口感染或脂肪液化率差异均有统计学意义(P<0.01),清扫淋巴结数量、宫旁或阴道切除范围差异无统计学意义(P>0.01)。术后随访2~3年,两组患者均无复发。结论:相较传统开腹手术,腹腔镜手术具有患者创伤小、并发症少、术后康复快等优点,腹腔镜广泛子宫切除术加盆腔淋巴结切除术治疗肥胖早期妇科恶性肿瘤患者是安全、可行的。
Objective: To evaluate the value of laparoscopic radical hysterectomy plus bilateral pelvic and para-aortic lymph node dissection in the treatment of patients with gynecologic malignancies. Methods: The clinical data of 20 patients with endometrial cancer and cervical cancer who underwent laparoscopic surgery from June 2009 to September 2013 were retrospectively analyzed. The operation time, blood loss, number of resected lymph nodes, postoperative anal exhaust Time and postoperative complications and other indicators, and with the same period of laparotomy for comparative analysis. Results: Twenty cases of laparoscopic surgery were successfully completed, and none of them was converted to laparotomy. The operation time, intraoperative blood loss, postoperative anal exhaust time, postoperative ambulation time, incision infection or fat liquefaction rate were significantly different (P <0.01), the number of lymph nodes dissection, uterine or vagina There was no significant difference in resection range (P> 0.01). Follow-up 2 to 3 years after operation, no recurrence was found in both groups. Conclusion: Compared with the traditional laparoscopic surgery, laparoscopic surgery has the advantages of less trauma, less complications and quick recovery, laparoscopic radical hysterectomy plus pelvic lymph node dissection in the treatment of patients with early stage obesity is safe and feasible of.