早期卵巢癌腹腔镜手术治疗的安全性和有效性分析

Safety and effectiveness of laparoscopic surgery for early ovarian cancer

摘要:

目的 探讨早期卵巢癌腹腔镜手术治疗的安全性和有效性。方法 选择2010年1月-2014年12月在浙江省肿瘤医院住院治疗的早期卵巢癌患者90例作为研究对象，将其随机分为腹腔镜手术组和开腹手术组。比较两组患者的年龄、体质指数（BMI）、卵巢癌直径、卵巢癌的分期、术中出血量、手术时间、周围脏器损伤、手术前后白蛋白差值、术后通气时间、术后住院时间、术后至首次化疗间隔时间、术后发烧情况、随访时间、术后并发症情况、术后复发和术后死亡情况。结果 腹腔镜手术组的术中出血量和手术时间少于开腹手术组（P < 0.05）。腹腔镜手术组的手术前后白蛋白差值少于开腹手术组（P <0.05），腹腔镜手术组的术后通气时间和术后至首次化疗间隔时间少于开腹手术组（P <0.05），腹腔镜手术组的术后发烧和术后并发症的发生率明显低于开腹手术组（P <0.05），腹腔镜手术组的术后复发率和术后死亡率稍高于开腹手术组，但差异无统计学意义（P > 0.05）。结论 腹腔镜手术治疗早期卵巢癌具有比较好的安全性和有效性，在改善早期卵巢癌患者术中和术后情况方面比开腹手术具有优势。

Abstract:

Objective To investigate the safety and effectiveness of laparoscopic surgery for early ovarian cancer. Methods Selected 90 early-stage ovarian cancer patients from January 2010 to December 2014 in Zhejiang Cancer Hospital as research subjects, and randomly divided into laparoscopic surgery group and laparotomy group. Then compared the age, BMI, ovarian cancer diameter, ovarian cancer staging, blood loss, operative time, surrounding organ damage, albumin difference before and after surgery, postoperative ventilation time, postoperative hospital stay, interval of postoperative to the first chemotherapy, postoperative fever cases, follow-up time, postoperative complications, postoperative recurrence and postoperative death in two groups. Results Blood loss and operative time of laparoscopic surgery group was less than that of laparotomy group (P < 0.05). Albumin difference before and after surgery of laparoscopic surgery group was less than that of laparotomy group (P < 0.05), postoperative ventilation time and interval of postoperative to the first chemotherapy of laparoscopic surgery group was less than that of laparotomy group (P < 0.05), the incidence of postoperative fever and postoperative complications of laparoscopic surgery group was less than that of laparotomy group (P < 0.05), the recurrence rate and postoperative mortality rate of laparoscopic surgery group were slightly higher than that of laparotomy group, but the difference was not statistically significant (P > 0.05). Conclusion Laparoscopic surgery for early-stage ovarian cancer has a relatively good safety and efficacy. Laparoscopic surgery has advantages over open surgery in improving early ovarian cancer intraoperative situation and postoperative situation.