Clinical Study Of Therapeutic Effect About Laparoscopy Surgery And Laparotomy Surgery In Treatment Of Endometriosis

Objective:to analyze the effect of the laparoscopy surgery and the laparotomy surgery in treatment of endometriosis.Methods:A retrospective study of225patients who were clinically diagnosed as endometriosis in our hospital from June2008to June2011, all cases have taken surgery in our hospital and were confirmed histologically endometriosis, including Ovarian endometriosis cyst、Pure endometriosis nodules、Peritoneal endometriosis、 merge uterine adenomyosis. The laparotomy group:107cases, the laparotomy group:60cases. After half a year we began to follow-up these cases, all patients were followed up for24months to48months, were followed up for more than two years.Meanwhile clinical staging is carried out according to the staging method modified by the American Fertility Association in1997, respectively to assess symptoms of two groups of patients such as amount of bleeding during the surgery, length of stays, menstruation pain after surgery, dyspareunia, chronic pelvic pain, paramenia, and to follow-up the anesis of clinical symptoms of two groups of patients after operation such as the postoperative recurrence rate, recurrence time, dysmenorrheal, dyspareunia, chronic pelvic pain and menstrual disorders.Results:1. comparison of perioperative period situation of the laparoscopy group and the laparotomy group:the operation time of the laparoscopy group (50.34±9.27) min, the operation time of the laparotomy group (89.30±13.75)min;(t:-21.98, P<0.05); the bleeding in operation of the laparoscopy group(52.42±13.14)ml, the bleeding in operation of the laparotomy group (116.85±26.78) ml;(t:-20.57, P<0.05); the postoperative anal exhaust time of the laparoscopy group(19.09±3.72)h, the postoperative anal exhaust time of the laparotomy group(33.09±7.42)h,(t:16.889, P<0.05); the postoperative analgesic usage rate of the laparoscopy group (32.71%) and the laparotomy group (83.75%); the postoperative fever disease rate of the laparoscopy group (8.41%) and the laparotomy group (32.5%); the postoperative hospital stay of the laparoscopy group (5.03±1.39)d, the postoperative hospital stay of the laparotomy group(7.31±0.98)d,(t:-17.79, P<0.05). Statistical analysis showed significant differences in the six results (P<0.05).2. comparison of symptoms relieved after operation of the laparoscopy group and the laparotomy group:after the operation, remission rate of menstruation pain of the laparoscopy group is75%, and that of the laparotomy group is68.18%, no significant differences (x2:1.08, P>0.05); remission rate of dyspareunia after operation of the laparoscopy group is80%, and that of the laparotomy group is77.78%, no significant differences (x2:0.13, P>0.05); remission rate of chronic pelvic pain after operations of the laparoscopy group is72%, and that of the laparotomy group is66.67%, no significant differences (x2:0.14, P>0.05); remission rate of irregular menstruation after operation of the laparoscopy group is66.67%, and that of the laparotomy group is62.5%, no significant differences (x2:0.08, P>0.05). These data indicate that the two groups of patients with postoperative pain relief and menstrual disorders correction without significant difference.3. comparison of the recurrence rate of the laparoscopy group and the laparotomy group:after more than2year’s follow-up, the recurrence rate of the laparoscopy group is11.21%and that of the laparotomy group is12.5%, the difference in the recurrence rate of the two groups has no statistical significance,(x2:0.008, P>0.05). The recurrence rate of the stage Ⅰ and stage Ⅱ is5.7%; The recurrence rate of the stage Ⅲ is8.2%; The recurrence rate of the stage Ⅳ is29.7%; The difference was significant, This showed that the more serious condition, more easy to relapse after operation.Conclusion:1. The operation time, the bleeding in operation, the postoperative anal exhaust time, the postoperative analgesic usage rate, the postoperative fever disease rate, the postoperative hospital stay were significantly better than the laparotomy group.2. The remission rate of menstruation pain±dyspareunia±chronic pelvic pain and irregular menstruation after operation of the laparoscopy group is same as the laparotomy group.3. The recurrence rate of the laparoscopy group is consistent with the laparotomy group, while the total recurrence rate was positively correlated with clinical stage.