Compare Of Laparoscopic Surgery And Laparotomy In Early Endometrial Cancer

ObjectiveEndometrial carcinoma is one of the most common gynecologic tumors, and the incidence increased year by year. Endometrial cancer in early stage can have the symptom such as irregular vaginal bleeding and/or flow fluid, so most of the endometrial carcinoma could be discovered in the early days, and most can reach the purpose of cured by surgery. The mortality is low.At present the main means for endometrial cancer surgery are robot assisted laparoscopic surgery, laparoscopic surgery and conventional laparotomy. Literature research shows that the minimally invasive surgery has greater advantage in the treatment of endometrial cancer. But there are differences in equipment and technology in different medical center, so the comparison results between laparoscopic surgery and laparotomy remain different. Through this study we retrospectively analyzed early endometrial carcinoma patients from February 2006 to February 2016 in our hospital that underwent surgical treatment, comparing laparoscopic surgery and open surgery in all aspects of the differences and effects.MethodsWe retrospectively analyzed 302 cases of patients with endometrial carcinoma who underwent surgical treatment from February 2006 to February 2006 in our hospital. We choose 86 cases of early stage Ⅰ-Ⅱ endometrial carcinoma underwent total hysterectomy with bilateral oophorectomy and lymphadenectomy, of which 52 cases are in laparoscopic group,34 cases are in laparotomy group. We compared two groups in operation time, intraoperative blood loss, intraoperative complications and pathological type, number of lymph node excision, postoperative hospital stay, anal exhaust recovery time, duration of indwelling urethral catheterization, survival rate and disease-free survival rate.ResultsThe basic characteristics of the two groups of preoperative patients include age, BMI, complications (hypertension, diabetes) and FIGO staging have no statistical difference(p> 0.05). Laparoscopic group average operation time was (184.33 ± 38.68) min, laparotomy group average operation time was (187.56 ± 58.70) min, the result has no significant difference (P> 0.05). Blood loss of is 40 (20-50) ml in laparoscopic group,200 (100-262.5) ml in laparotomy group, and laparoscopic intraoperative blood loss was significantly less than laparotomy group (P< 0.01). In laparoscopic group there is 1 case of ureteral injuries (1.92%), no one case of intraoperative blood transfusion. In laparotomy group there is no ureteral injury, but 2 cases of intraoperative blood transfusion (5.88%). The postoperative hospital stay of laparoscopic group was (5.71±1.91) days, shorter than laparotomy group (8.88 ±2.79) days, the result has significant difference (P< 0.01); The hospitalization cost for the laparoscopic group is (25174.99 ± 4242.66) Yuan, more than laparotomy group (20347.89 ± 3915.88) Yuan, the result has significant difference (P< 0.01). Resection of lymph node number is (20.25±9.02) in laparoscopic group and (17.97 ± 8.34) in laparotomy group, there was no significant difference in the two groups (P> 0.05). Postoperative anal exhaust time is (2.25 ± 0.56) days in Laparoscopic group, (3.41 ± 0.86) days in laparotomy group, the laparoscopic group recovery of anal exhaust time is shorter (P< 0.01). Postoperative indwelling catheter time was (2.38 ± 0.75) days in Laparoscopic group, (3.76 ± 1.13) days in laparotomy group, the laparoscopic group postoperative indwelling catheter time is shorter (P< 0.01). In laparoscopic group 5-year survival rate was 95.5%, while in laparotomy group 5-year survival rate was 92.9%. The result has no significant difference (P> 0.05). The 5-year disease-free survival rate was 93.2% in the laparoscopic group and 89.3% in laparotomy group. The result has no significant difference (P> 0.05).ConclusionThis study shows that laparoscopy and laparotomy have similar effect in the treatment of early endometrial carcinoma, but laparoscopy has the advantage of smaller trauma, less intraoperative bleeding and faster postoperative recover and higher absolute survival rate, it can be used as one of the priority of endometrial carcinoma treatment.