CAJ | 학술논문

目的：研究腹腔镜下广泛子宫切除术在治疗子宫恶性肿瘤中的临床疗效。方法：2008年6月至2012年8月于我院妇科行腹腔镜下广泛性子宫切除术和盆腔淋巴结清扫术(TLRH+LPL)57例(腹腔镜组)及行传统开腹手术的100例(开腹组)确诊为宫颈癌/子宫内膜癌患者的病历资料。比较两组的手术时间、术中出血量、术中清扫盆腔淋巴结数量，术后肛门排气时间、术后导尿管留置时间等手术情况、住院时间以及两组并发症的发生率。结果：腹腔镜组手术时间、术中出血量均显著长于对照组(P<0.01)，清扫盆腔淋巴结数量显著多于对照组(P<0.01)。腹腔镜组术后肛门排气时间、术后住院时间明显短于对照组(P<0.01)，两组术后导尿管留置时间无显著差异(P>0.05)。腹腔镜组并发症总发生率为14.0%，对照组并发症总发生率为18.0%，两组并发症总发生率差异均无显著性(P>0.05)。结论：腹腔镜下广泛性全子宫切除术和盆腔淋巴结清扫术较开腹手术比较具有创伤小、恢复快，在不增加手术风险的基础上其手术疗效肯定，可在临床上广泛开展应用。
목적：연구복강경하엄범자궁절제술재치료자궁악성종류중적림상료효。방법：2008년6월지2012년8월우아원부과행복강경하엄범성자궁절제술화분강림파결청소술(TLRH+LPL)57례(복강경조)급행전통개복수술적100례(개복조)학진위궁경암/자궁내막암환자적병력자료。비교량조적수술시간、술중출혈량、술중청소분강림파결수량，술후항문배기시간、술후도뇨관류치시간등수술정황、주원시간이급량조병발증적발생솔。결과：복강경조수술시간、술중출혈량균현저장우대조조(P<0.01)，청소분강림파결수량현저다우대조조(P<0.01)。복강경조술후항문배기시간、술후주원시간명현단우대조조(P<0.01)，량조술후도뇨관류치시간무현저차이(P>0.05)。복강경조병발증총발생솔위14.0%，대조조병발증총발생솔위18.0%，량조병발증총발생솔차이균무현저성(P>0.05)。결론：복강경하엄범성전자궁절제술화분강림파결청소술교개복수술비교구유창상소、회복쾌，재불증가수술풍험적기출상기수술료효긍정，가재림상상엄범개전응용。
Objective:To compare the clinical efficacy between laparoscopic and laparotomy for patients with malignant uterine tumors.Methods:The clinical data of 100 cases treated with laparotomy (control group) and 57 cases of total laparoscopic radical hysterectomy (TLRH) and pelvic lymphadenectomy(laparoscopic group) who diagnosed with cervical cancer and endometrial cancer were retrospectively analyzed. The two groups were compared in operative time, blood loss, number of pelvic lymph node dissection in surgery, postoperative anal exhaust time, postoperative catheterization time, length of stay, and complications in the two groups the incidence.Results:Laparoscopic operative time in laparoscopic group was significantly longer than that in the control group (P<0.01) and blood loss in laparoscopic group was significantly more, than that in the control group (P<0.01) the dissection of pelvic lymph nodes was significantly more than the control group (P<0.01) in the number. The laparoscopic group anal exhaust time, postoperative hospital stay was significantly shorter than the control group (P<0.01), postoperative catheterization time was no significant difference between the two group(P>0.05). Complicat18.0%in the control group (P>0.05).Conclusion:TLRH+LPL under laparoscopic has the feature of trauma, quicker recovery than laparotomy, which does not increase the risk of surgery and should be extensively applied in clinic.