Vaginal versus abdominal hysterectomy in endometrial cancer: a retrospective study in a selective population
Vaginal versus abdominal hysterectomy in endometrial cancer: a retrospective study in a selective population
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DOI：
10.1111/j.1525-1438.2007.01091.x
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发表时间：
2008-07-01
影响因子：
4.8
通讯作者：
Nardelli, G. B.
中科院分区：
文献类型：
--
作者：
Berretta, R.;Merisio, C.;Nardelli, G. B.
本研究的目的是分析经阴道和经腹子宫切除术治疗选定的老年患者组早期子宫内膜癌的结果。这项回顾性研究总共分析了 154 名患者：113 名（第一组）接受了阴道手术，41 名（第二组）接受了剖腹手术。在两组中，我们研究了以下参数：术中和术后并发症、平均手术时间、平均住院时间、无病生存期（DFS）、总生存期（OS）以及局部或腹膜后复发时间。阴道手术组中出现医学问题的患者明显更高（P = 0.005），并且该组的手术时间明显更短（P = 0.01）。两组的术中和术后并发症以及局部和远处复发没有显示出统计学上的显着差异。两个人群的 5 年总生存率为 85%，无论是在 DFS 方面还是在 OS 方面都没有达到统计学上的显着差异。与传统腹部手术相比，阴道手术对于手术风险高的患者也是可行的；它不需要全身麻醉，消除了与剖腹手术相关的腹部创伤，并且可以更快地恢复膀胱和直肠功能；因此，它实现了高根除率和低术中和术后发病率。
The purpose of this study was to analyze the outcome of vaginal and abdominal hysterectomy for the treatment of early-stage endometrial cancer in a selected group of elder patients. This retrospective study analyzed a total of 154 patients: 113 (group I) underwent vaginal surgery and 41 (group II) underwent laparotomy. In both groups, we investigated the following parameters: intra- and postoperative complications, mean operative time, mean hospital stay, disease-free survival (DFS), overall survival (OS), and time of local or retroperitoneal recurrence. Medically compromised patients were significantly more frequent in the vaginal surgery group (P = 0.005), and the operative duration in this group was significantly shorter (P = 0.01). Intra- and postoperative complications, along with local and distant recurrence, did not show a statistically significant difference in the two groups. Total survival in the two populations, 85% at 5 years, did not reach statistically significant difference either in terms of DFS or in terms of OS. Vaginal surgery compared to traditional abdominal approach is feasible also in patients with high surgical risk; it does not require general anesthesia, abolishes abdominal trauma correlated to laparotomy, and allows a quicker reprise of the bladder and rectal function; therefore, it achieves high eradication rates and low intra- and postoperative morbidity rates.