| Objectives:To investigate the clinical efficacy of laparoscopic surgery for the management of early endometrial carcinoma based on our hospital reality.Methods:We retrospectively analyzed 28 patients with endometrial carcinoma who underwent laparoscopic surgery and 32 patients underwent traditional abdominal surgery in Department of Obstetrics and Gynecology in the Clinical Medical College of Yangzhou University, Subei People’s Hospital from January 2010 to October 2015. All the surgery included in the study were completed under the same conditions of equipment by the same surgeon team. The clinical data and pathological data integrity, and all subjects were followed up, we retrospectively studied the continuous data recording using SPSS 19.0 software.Results:The blood loss of laparoscopy group and laparotomy group were (243.5±41.3)ml and (298.7± 39.5)ml respectively, anal exhaust time were respectively (2.01±0.18)d and (2.87±1.62)d, indwelling catheter time were respectively (2.51±2.01)d and (3.98±3.01)d and hospital stay were respectively (5.8±3.4)d and (7.6±4.8)d, differences between above data of the two groups were statistically significant (P<0.05). The rate of complications were respectively 6.3% and 11.4%, laparoscopic group had advantage in wound healing which P<0.05. The operation time were respectively (212.5±90.2)min and (205.8±81.5)min which P>0.05. The average length of parametrial tissue removed were respectively (2.38±0.46)cm and (2.51±0.58)cm, average vaginal resection length were (2.67±0.43)cm and (2.70±0.45)cm, which all P>0.05. And also, there were no differences in the two groups in terms of the number of excised lymph nodes, pelvic lymph node respectively (18.5±3.4) and (18.2±2.3), aortic lymph node respectively (3.77±1.82) and (3.82±2.05). Taking follow-ups into account, the adjuvant treatment and median survival time of two groups were similar. The recurrence rate, disease-free survival rate and overall survival rate of the laparoscopic group were 3.57%,96.00% and 92.59%, respectively were 3.13%,96.55% and 93.55% in the laparotomy group, which with no statistically difference (P>0.05).Conclusion:Laparoscopic surgery had the following characteristics based on the small sample clinical research of our hospital in early endometrial carcinoma1. Less bleeding, earlier intestinal function recovery, shorter of indwelling catheter time and hospitalization time.2. Better in incision healing, the total complication rate has no difference.3. Surgical resection was completely done, length of parametrial tissue, vagina and number of lymph node were comparable to those of the abdominal group.4. Recurrence rate, disease-free survival and overall survival rate were similar to abdominal surgery.We had reasons to believe that laparoscopic surgery done by the experienced gynecologists which grasp indications is safe and feasible, the long-term prognosis in patients also need large multi-center prospective randomized controlled clinical trials. |
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