Objective: To explore the clinical efficacy of radical hysterectomy and pelvic lymphadenectomy under laparo-scope for the treatment of uterine malignancy. Methods: From January 2009 to February 2011, 46 patients with cervical cancers or endometrial cancer received radical hysterectomy and pelvic lymphadenectomy by laparoscopy (laparoscopy group) in our hospital. Meanwhile, 41 patients with the two uterine malignancy underwent the same treatment by open surgery (open surgery group). The clinical data including the operation time, intraoperative blood loss, the number of resect -ed lymph nodes, recovery time of gastrointestinal function, indwelling catheter time and hospital stay between the two groups were analyzed. Results: Compared to the open surgery group, intraoperative blood loss of the laparoscopy group was less [(350±162)ml vs (473±199)ml, t=3.175, P=0.002 0], and hospital stay time was shorter [(8.1±4.3)d vs (11.3±5.0)d, t= 3.21, P=0.001 0], and recovery time of gastrointestinal function was shorter [(45±3)h vs (48±4)d,t=3.98, P=0.000 1]. No significant difference was observed in the the operation time, removal of lymph nodes and indwelling catheter time between the two groups (P>0.05). Conclusion: Extensive laparoscopic hysterectomy and pelvic lymphadenectomy have advantages of minimally invasive and effective and can be widely carried out.%目的:探讨腹腔镜下行广泛子宫切除和盆腔淋巴结清扫术治疗子宫恶性肿瘤的临床效果.方法:回顾性分析2009年1月~2011年2月46例行腹腔镜手术(腹腔镜组)与41例同期行开腹手术(开腹组)广泛切除子宫、清扫盆腔淋巴结的子宫内膜癌和子宫颈癌患者的临床资料,观察两组的手术时间、术中出血量、淋巴结切除数量、肛门开始排气时间、留置尿管时间及平均住院日等.结果:与开腹组相比,腹腔镜组术中出血量少[(350±162)ml vs(473±199)ml,t=3.175,P=0.002 0],住院时间短[(8.1±4.3)d vs(11.3±5.0)d,t=3.21,P=0.001 0],肛门开始排气时间短[(45±3)h vs(48±4)d,t=3.98,P=0.000 1];两组患者手术时间、切除淋巴结数量、留置尿管时间比较,差异无统计学意义(P>0.05).结论:腹腔镜下行广泛性全子宫切除加盆腔淋巴结清除术具有创伤小,恢复快等优点,具有良好运用前景.
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