| Objective: Our study was designed to compare and analyze retrospectively the short-term and long-term results of laparoscopic comprehensive staging for apparent e EOC with those obtained with surgery via laparotomy in terms of safety,efficacy and outcome,SO as to investigate the value of laparoscopy in comprehensive staging for apparent e EOC.Methods: An estimated 221 of consecutive patients with apparent early-stage epithelial ovarian cancer(e EOC)who underwent laparoscopy(LPS group,n=69)or laparotomy(LPT group,n=152)in the Fourth Hospital of He Bei Medical University from January 2009 to January 2019.All patients were diagnosed with e EOC by frozen and paraffin pathology examination according to the latest standard of staging FIGO staging criteria(2013)to surgical pathologic staging with FIGO I～II period.The general data and perioperative parameters of the two groups were compared,and the survival outcomes were analyzed.SPSS R3.6.1 software was used for statistical analysis.After the normality test,all the measurement date were in line with the normal distribution.?x±s was used to describe the measurement data,and independent sample t test was performed.chi square test was performed to describe the counting data of case number and percentage.Survminer and survival packages were used to calculate survival rates and draw survival curves.P < 0.05 was considered statistically significant.Results:1.Comparison of general data between the two groupsThe age of the laparoscopic group ranged from 15 to 71,with a median age of 48 and an average age of(45.7±14.4).The age of the laparotomic group ranged from 14 to 72,and the median age was 51,with an average age of(50.5±9.6),and the difference was statistically significant(P<0.05).There was no significant difference between the two groups in BMI,menopausal status,abdominal operation history,preoperative serum CA125 and concomitant disease(P>0.05).2.Comparison of perioperative indicators between the two groupsThe average tumor diameter was(9.1±4.1)cm in the laparoscopic group and(10.7±4.8)cm in the laparotomic group,with statistically significant differences(P<0.05).LPS had larger number of the number of para-aortic lymph nodes[(6.9±6.5)vs(4.2±4.7)],less intra-operative blood loss[(148.2 ±179.9)ml vs(273.4±219.2 ml)],shorter gastrointestinal recovery time[(2.5±0.6)days vs(2.9±0.9)days]and shorter hospital stay[(9.7±3.3)days vs(11.6±4.2)days] when compared with LPT group(P<0.01).No significant difference was found in the number of pelvic lymph node resection,the rate of intraoperative tumor rupture,the indwelling time of abdominal drainage tube,and the starting time of postoperative chemotherapy(P>0.05).3.Comparison of postoperative complications between the two groupsNo significant difference was found in postoperative rate of complications[9.9%(15/152)vs 5.8%(4/69),P>0.05].4.Comparison of survival outcomes between the two groupsNo significant difference was found in recurrence rate [17.1%(26/152)vs 13.0 %(9/69),P>0.05]and 5-year overall survival[89% vs 88%(9/69),P>0.05].Conclusions:1.By retrospectively comparing and analyzing the feasibility and safety of laparoscopy and laparotomy in surgical staging of early-stage epithelial ovarian cancer(e EOC),laparoscopic staging,shows more favorable operative outcomes including less intra-operative blood loss and quicker recovery when compared with LPT groups.2.Laparoscopic surgery is safe and feasible in selected patients with early-stage epithelial ovarian cancer. |
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