[Comparison of the short-term and long-term outcomes of laparoscopic surgery and open surgery for early-stage cervical cancer].
[Comparison of the short-term and long-term outcomes of laparoscopic surgery and open surgery for early-stage cervical cancer].
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DOI：
10.3760/cma.j.issn.0253-3766.2017.06.011
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发表时间：
2017-06-23
期刊：
影响因子：
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通讯作者：
Li, L
中科院分区：
文献类型：
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作者：
He, H Y;Yang, Z J;Li, L
目的：评价腹腔镜手术与传统开腹手术治疗ⅠA2-ⅡA2期宫颈癌的近期和远期疗效。方法：对广西省6家三级甲等医院2007年1月至2014年5月收治的1 863例FIGOⅠA2～ⅡA2期宫颈癌患者的临床资料进行回顾性研究，其中腹腔镜检查1071例，开腹手术792例。使用T检验、U检验和chi(2)检验来比较短期和长期结果。短期结局包括手术相关结局和手术并发症，长期结局包括生活质量（盆底功能和性功能）、生存和复发。盆底功能和性功能分别通过女性下尿路失禁问卷调查（ICIQ-FLUTS）和女性性功能量表（FSFI）进行评估。通过卡普兰-迈耶分析估计存活率。将生存曲线与Log-rank检验进行比较。 Cox回归分析用于评估预后的危险因素。结果：（1）近期疗效：手术时间[（257±69）vs（238±56）min]、预计失血量[（358±314）vs（707±431）ml]、肛门排气时间[（2.5±0.9）vs（2.9±0.8）d]、导管保留天数[（15±7）天]差异有统计学意义。 腹腔镜手术组与开腹组术后住院时间[(19±16) vs (30±21)d]比较(P<0。05)。腹腔镜手术组术中并发症发生率为8.1%（87/1 071），开腹手术组为10.7%（85/792）。 组(P>0.05)。但腹腔镜手术组血管损伤并发症[2.6%(28/1 071)]低于开腹手术组[7.7%(61/792),P<0。05)。 (3)预后因素：单因素分析显示，肿瘤大小、临床分期、深部间质侵犯、LVSI和腹膜后淋巴结转移显着影响5年OS和5年DFS(P
Objective: To evaluate the short-term and long-term outcomes after laparoscopic surgery compared with traditional laparotomy in cases of stage ⅠA2-ⅡA2 cervical cancer. Methods: We conducted a retrospective study on the clinical data of 1 863 patients diagnosed as FIGO stages ⅠA2-ⅡA2 cervical cancer in 6 third-grade class-A hospitals in Guangxi province between January 2007 and May 2014. One thousand and seventy-one received laparoscopy, and 792 received laparotomy. T-test, U-test and chi(2) test were used to compare the short-term and long-term outcomes. The short-term outcomes included surgical related outcomes and operative complications, and the long-term outcomes included quality of life (pelvic floor functions and sexual functions), survival and recurrence. Pelvic floor function and sexual function were assessed with the International Consultation on Incontinence Quesonnaire Female Lower Urinary tract(ICIQ-FLUTS) and the Female Sexual Function Inventory (FSFI), respectively. Survival rates were estimated by Kaplan-Meier analysis. The survival curves were compared with Log-rank test. Cox regression analysis was used to evaluaterisk factors for prognosis. Results: (1)The short-term outcomes : There were significant difference in operative time([(257±69) vs(238±56)min], estimated blood loss[(358±314) vs(707±431)ml], anus exhausting time[(2.5±0.9) vs (2.9±0.8)d], preserved days of catheter[(15±7) vs(18±9)d], and post-operative length of stay[(19±16) vs (30±21)d] between the laparoscopic surgery group and the opensurgery group(P0.05). The intra-operative complications occurred in 8.1%(87/1 071)in the laparoscopic surgery group and in 10.7%(85/792)in the open surgery group(P>0.05). However, the complications of vascular injury in the laparoscopic surgery group[2.6%(28/1 071)]was lower than that in the open surgery group[7.7%(61/792), P0.05). (3) Prognostic fators: In univariate analysis, tumor dimension, clinical stage, deep stromal invasion, LVSI, and retroperitoneal lymph node metastasis signficantly affected 5-year OS and 5-year DFS(P