Laparoscopic Approach in Surgical Staging of Endometrial Cancer
Laparoscopic Approach in Surgical Staging of Endometrial Cancer
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DOI：
10.1055/s-0039-1688461
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发表时间：
2019-05-01
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影响因子：
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通讯作者：
Martins, Francisco Nogueira
中科院分区：
文献类型：
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作者：
Mouraz, Mariana;Ferreira, Cátia Sofia;Martins, Francisco Nogueira
目的比较腹腔镜手术与开腹手术对子宫内膜癌手术分期的影响。主要研究终点为：发病率和死亡率、住院时间、围手术期不良事件和复发率。用软件SPSS v25（IBM Corp.，阿尔蒙克，纽约，美国），分类变量使用卡方和Fisher检验，连续变量使用Student t检验。138例患者符合纳入标准，其中41例通过腹腔镜进行分期，97例通过剖腹手术进行分期。2例患者（4.9%）从腹腔镜转为开腹手术，继发于技术困难和暴露不良。与开腹手术相比，腹腔镜手术的术后不良事件较少（分别为7.3%和23.7%; p = 0.005），但术中并发症发生率相似，尽管手术时间明显较长（中位数分别为175和130分钟; p < 0.001）。腹腔镜手术患者的住院时间明显低于剖腹手术患者（中位数分别为3天和7天; p < 0.001）。结论腹腔镜手术分期子宫内膜癌是安全可行的。与开腹手术相比，患者术后并发症发生率较低，住院时间较短。
Objective To compare laparoscopy with laparotomy for surgical staging of endometrial cancer.Methods A cohort of women with preoperative diagnosis of endometrial cancer who underwent surgical staging was retrospectively evaluated. The main study end points were: morbidity and mortality, hospital length of stay, perioperative adverse events and recurrence rate. Data analysis was performed with the software SPSS v25 (IBM Corp., Armonk, NY, USA), categorical variables using a Chi-square and Fisher test, and continuous variables using the Student t-test.Results A total of 162 patients were analyzed. 138 patients met the inclusion criteria, 41 of whom underwent staging by laparoscopy and 97 by laparotomy. Conversions from laparoscopy to laparotomy happened in 2 patients (4.9%) and were secondary to technical difficulties and poor exposure. Laparoscopy had fewer postoperative adverse events when compared with laparotomy (7.3% vs 23.7%, respectively; p = 0.005), but similar rates of intraoperative complications, despite having a significantly longer operative time (median, 175 vs 130 minutes, respectively; p < 0.001). Hospital stay was significantly lower in laparoscopy versus laparotomy patients (median, 3 vs 7 days, respectively; p < 0.001). No difference in recurrence or mortality rates were observed.Conclusion Laparoscopic surgical staging for endometrial cancer is feasible and safe. Patients have lower postoperative complication rates and shorter hospital stays when compared with the approach by laparotomy.