| Objective:To evaluate the efficacy of laparoscopic and abdominal surgery of EC for the references to therapeutic schedule of clinical treatment plan.Methods:The clinical datas of EC patients who received laparoscopic or open surgery in the department of gynaecology of Zunyi Medical University from January 2010 to December 2017 were retrospectively analyzed.Among them,There were 96 patients in the laparoscopic group and 70 patients in the open group in stage I,and 13 patients in the laparoscopic group and 11 patients in the open group in stage II.Respectively compare the indicators including operative time,intraoperative blood loss,the number of lymph nodes removed,intraoperative and postoperative complications,postoperative hospital stay,recovery time of anal exhaust,indwelling time of abdominal negative pressure tube and indwelling time of urethral catheterization and so on,and calculate survival rate finally.Results:1 Comparison of patients’ general information:the age distribution of laparoscopic group was(52.08±8.35)years old,and that of open group was(54.52±9.24)years old.BMI was(24.92±4.02)in the laparoscopic group and(24.20±3.36)in the open group.The complications(hypertension,diabetes,hyperlipidemia,etc.)were 41.28%(45/109 cases)in the laparoscopic group and 39.50%(32/81 cases)in the open group,.The difference between the two groups was not statistically significant(P > 0.05).2 Comparison of laparoscopic and open group in stage I Intraoperative conditions: 1)Operation time:(245.73±48.77)min in the laparoscopic group and(222.51±40.81)min in the open group,the difference between the two groups was statistically significant(P<0.05).2)Inoperative blood loss: the laparoscopic group was(119.58±57.87)ml,and the others was(276.40±99.16)ml,the difference was statistically significant(P < 0.05).3)Intraoperative complications: the incidence in the laparoscopic group was 3.13%(1 case of intestinal injury and 2 cases of ureteral injury),while no complications occurred in the open group,suggesting that the absolute number of complications during laparoscopic surgery was higher than that during open surgery,but the difference between the two groups was not significant(P>0.05).4)Number of lymph nodes dissected: The number of lymph nodes dissected during stage I-II was(29.11±5.16)in the laparoscopic group and(27.97±6.34)in the open group,with no significant difference(P>0.05).Postoperative conditions: 1)Postoperative complications: The incidence of laparoscopic group was 4.16%(lymph cyst 2 cases,intestinal obstruction in 1 case,lower limb venous thrombosis in 1 case),open group was 14.28%(lymph cyst 1 case,intestinal obstruction in 2 cases,lower limb venous thrombosis in 3 patients,4 cases were poor healing of incision),incidence in postoperative complications of laparoscopic group was significantly less than laparotomy group(P<0.05).2)Recovery: The recovery time of gastrointestinal function in the laparoscopic group was(2.59±0.83)days,and that in the open group was(3.00±0.79)days.The urethral catheterization time in laparoscopic group was(3.33±1.51)days,and that in open group was(4.07±1.90)days.The average postoperative hospitalization time of the laparoscopic group was(8.96±4.21)days,and that of the open group was(12.95±7.28)days,indicating that the postoperative recovery of gastrointestinal function,urethral catheterization time and postoperative average hospitalization time of the laparoscopic group were better than those of the open group(P<0.05).Prognosis: The 3 and 5-year survival rates in the laparoscopic group were 96.87% and93.75%,and that were 94.28% and 91.42% in the open group,The difference was not significant(P>0.05).3 Comparison of laparoscopic and open group in stage II Intraoperative conditions: 1)Operation time:(270.76±40.29)min in the laparoscopic group and(250.27±25.18)min in the open group.The time in the open group was shorter than that in the laparoscopic group,but the difference between the two groups was not significant(P>0.05).2)Intraoperative blood loss: it was(126.92±75.98)ml in the laparoscopic group and(294.54±37.51)ml in the open group,indicating that the blood loss in the laparoscopic group was significantly less than that in the open group(P<0.05).3)Intraoperative complications: No intraoperative complications occurred in the two groups.Postoperative conditions: 1)Postoperative complications: 7.6% of patients in the laparoscopic group(1 case of lymphatic cyst)and 18.18% of patients in the open group(1case of deep vein thrombosis of the right lower extremity and 1 case of poor wound healing)were found in the laparoscopic group.Postoperative complications in the laparoscopic group were lower than those in the open group,but the difference was not significant(P>0.05).2)Recovery: The recovery time of gastrointestinal function in the laparoscopic group was(2.69±0.75)days,and that in the open group was(3.27±0.46)days.The average postoperative hospitalization time of the laparoscopic group was(8.84±2.03)days,and that of the open group was(11.18±2.35)days,The results showed that the postoperative recovery of gastrointestinal function and postoperative hospital stay were better than those in the open group(P<0.05).There was no significant difference in the urethral catheterization time of urinary catheter and negative pressure drainage tube between the two groups(P>0.05).Prognosis: The 5-year survival rates of the laparoscopic group were 69.23%,and that of the open group were 63.63%,The difference was not significant(P>0.05).Conclusion : Laparoscopic surgery not only has the short-term advantages of less intraoperative bleeding,low incidence of postoperative complications,faster recovery of gastrointestinal function and shorter average hospital stay,but also has the similar long-term efficacy with abdominal surgery in the treatment of EC,which can be used as the preferred opreation for endometrial cancer. |
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