Comparative Analysis Of Laparoscopic Surgery And Laparotomy For Early-stage Endometrial Cancer

Background:Endometrial cancer is the one of most common female reproductivetract of cancer, accounting for7%of all women malignant tumor, accounting for20%~30%of the female reproductive tract malignant tumor, close to cervical cancer. Inrecent years its incidence is obviously rising in around the world, according to the reportin2008, global endometrial carcinoma were more than40000cases. With thedevelopment of society, and the per capita increased age, high blood pressure, diabetes,obesity increases, laparotomy increases the postoperative complications, the mortalityrate also doubled. In recent years, with the popularity of laparoscopic techniques, lots ofgynecological tumor doctors suggest the application of laparoscopic treatment in earlyendometrial cancer.Objective:Research showed that laparoscopic surgery was safe and feasible in theearly endometrial cancer.The aim of this study was to compare126cases of patientswith early-stage endometrial cancer， this paper discussed the feasibility, safety andsurvival comparison in laparoscopic and laparotomy.Methods:We analyzed retrospectively126cases of endometrial carcinomapatients with early clinical pathology material of maternity hospital in dalian in January2008to October2011, laparoscopic surgery in73cases, choosed the same periodlaparotomy in53cases, two groups of patients with perioperative and postoperativecurative effect contrast. Staging surgery including: basin abdominal exploration, ascitescytologic examination, the uterus and double accessories resection, pelvic lymphnodesdissections and/or abdominal aortic lymph node dissections.Result:Two groups of patients laparoscopic and laparotomy were in the age、bodymass index、menopause、delivery times、high blood pressure and diabetes, P>0.05; The average time for surgery were respectively (199.78±58.21)min and (170.21±6.28)min,P <0.01; The average amount of blood loss were respectively (192.47±88.46) ml and(398.11±185.01) ml, P <0.01; The average length of hospital stay were respectively(17.71±4.70)d and (20.77±6.03) d, P <0.01; The average exhaust time wererespectively (2.21±0.47)d and (2.53±0.50)d, P <0.01; The average time forcatheterization lien were spectively(2.28±2.22)d and (2.30±2.12)d, P>0.05;Complication rate were respectively16.44%and28.30%, P>0.05; In the surgicalpathology classification, stages and pathological types, P>0.05; The average number oflymph node resection pelvic cavity were respectively (19.85±6.56) and (21.06±6.89), P>0.05; the average number of lymph node resection by the abdominal aorta wererespectively (3.95±1.86) and (4.00±3.74), P>0.05.Conclusion:Small sample size clinical studies showed that, laparoscopic treatmentin early endometrial cancer was safe and feasible and effective in strict controlindications conditions.Although operation time was long, but less bleeding andpostoperative recovery peristalsis fast, small trauma, quick recovery, incision artistic,and clinical curative effect must etc, and was worth more center, prospectie, randomized,controlled clinical studies to determine the laparoscopic surgery of value in the earlyendometrial cancer treatment.