Learning Curve of Laparoscopic Radical Hysterectomy With Pelvic and/or Para-Aortic Lymphadenectomy in the Early and Locally Advanced Cervical Cancer Comparison of the First 50 and Second 50 Cases
Learning Curve of Laparoscopic Radical Hysterectomy With Pelvic and/or Para-Aortic Lymphadenectomy in the Early and Locally Advanced Cervical Cancer Comparison of the First 50 and Second 50 Cases
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DOI：
10.1111/igc.0b013e3181b76640
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发表时间：
2009-11-01
影响因子：
4.8
通讯作者：
Lee, Yoon Soon
中科院分区：
文献类型：
--
作者：
Chong, Gun Oh;Park, Nae Yoon;Lee, Yoon Soon
背景：比较腹腔镜下根治性子宫切除术前50例与后50例的手术、肿瘤预后及发病率。方法：1994年10月至2004年1月，我们回顾性回顾了100例连续行腹腔镜根治性子宫切除术合并盆腔和/或主动脉旁淋巴结切除术的患者（国际妇产科联合会分期IA2 [n = 12]、IB1 [n = 56]、IB2 [n = 15]、IIA [n = 15]和1113 [n = 2]）的病历。100例患者分为前50例（第一组）和后50例（第二组）。结果：与2组比较，1组手术时间、住院时间、正常残尿时间、输液率均显著降低，盆腔淋巴结获得数显著增加。与1组相比，2组术中及术后并发症发生率显著降低。中位随访66.5个月后，10名患者复发，其中9人死亡。1组5年总生存率为96%，2组为90%，1组5年无病生存率为92%，2组为90%。结论：腹腔镜根治性子宫切除术是一种可行、安全的治疗早期甚至局部晚期宫颈癌的方法，且不会降低生存率。手术效果随经验的增加而提高，且I组手术相关并发症发生率高于2组。两组患者的生存率无显著差异。
Background: To compare the surgical and oncological outcomes and morbidity of the first 50 cases treated by laparoscopic radical hysterectomy with those of the second 50 cases.Methods: Between October 1994 and January 2004, we retrospectively reviewed the charts of 100 consecutive patients (International Federation of Gynecology and Obstetrics stages IA2 [n = 12], IB1 [n = 56], IB2 [n = 15], IIA [n = 15], and 1113 [n = 2]) who underwent laparoscopic radical hysterectomy with pelvic and/or para-aortic lymphadenectomy. One hundred patients were divided into the first 50 cases (group 1) and second 50 cases (group 2).Results: Operating time, length of hospital stay, time to normal residual urine, and transfusion rate significantly decreased, and the acquired number of pelvic nodes significantly increased when comparing group I with group 2. The intraoperative and postoperative complication rates profoundly decreased in group 2 as compared with group 1. After a median follow-up of 66.5 months, 10 patients had a recurrence, 9 of whom died. The 5-year overall survival rates were 96% in group I and 90% in group 2, and 5-year disease-free survival rates were 92% in group I and 90% in group 2.Conclusions: Laparoscopic radical hysterectomy is a feasible and safe treatment modality in early and even locally advanced cervical cancer without decreasing survival. Surgical outcome was improved with experience, and the complication rate related to operation of group I was higher than that of group 2. There was no significant difference in survival between the 2 groups.