Clinical Analysis Of Laparoscopy And Traditional Laparotomy In The Treatment Of Early Cervical Cancer

Research background:At present,abdominal extensive radical hysterectomy(ARH)+ pelvic lymphadenectomy(APL)is regarded as the standard surgical treatment for early cervical cancer(stage I A2 ~ II A).Although there are many comparative studies on the clinical treatment of early cervical cancer by laparoscopy and abdominal surgery,,there is still a lack of large sample and systematic comparison of clinical reports.Therefore,this paper uses the Meta analysis for ARH+APL and Laparoscopic extensive radical hysterectomy(LRH)+ pelvic infiltration(LPL)systematic reviews were conducted,in order to provide theoretical basis for gynecologic oncologists to choose surgical approaches reasonably in clinical work..Objective:In this project,the Meta analysis was used to systematically compare and evaluate the safety and effectiveness of the two types of LRH+LPL and ARH+APL in the treatment of early cervical cancer.Method:By retrieving the databases of PubMed,Elsevier,Medline,CNKI,Embase,Wan Fang,VIP and so on,the clinical literature of the early cervical cancer in the medical library of Nanchang University was retrieved manually.At the same time,a retrospective case control study,a randomized controlled study,and a prospective cohort study were selected.The time limit is from January 2007 to December 2017,and the language is limited to Chinese and English.After the inclusion and exclusion criteria are set up in this paper,the literature is screened strictly.The early cervical cancer surgical treatment documents which conform to the standard of this study will be selected,and the relevant systems in the Cochrane collaboration network will be selected.The evaluation principles and methods were evaluated.Finally,Revman5.3 software was used to do Meta analysis and Research on the extracted comparative data.Result:32 articles related to the clinical treatment of early cervical cancer were included,including 1 prospective cohort studies,24 retrospective case-control studies and 7 randomized controlled studies,covering 4152 patients with early cervical cancer.The results of Meta analysis showed that:The results of the number of lymph node excision showed that SMD=0.25,the results were statistically significant(Z=2.24,P=0.03);the results of comparison of the operation time indicated that SMD=0.42,the results of the test were statistically different(Z=3.21,P=0.001);the results of blood loss in the operation showed SMD= 1.,69(95%CI:-2.6-1.31),test knot The results were statistically significant(Z=8.83,P < 0.00001),and the results of postoperative complications were indicated by the comparison of OR=0.51(95%CI:0.43 to 0.61),and the results showed significant difference(Z=7.66,P < 0.00001).The recurrence rate of 1-5 year follow-up after the operation showed OR=0.93(95%CI: 0.66 ~ 1.29),and there was no significant difference in the results.Difference(Z=0.45,P=0.65);the results of other outcome indicators showed that the postoperative exhaust time of ECC patients combined with MS =-1.3,Z=8.65,P < 0.001;ECC patients after operation(day): combined with MS =-1.7,Z=6.93,P < 0.001,and the postoperative retention time of the patients in ECC: combined with M D =-0.73,Z=3.04,P < 0.05.In conclusion,the difference between the two groups was statistically significant(P < 0.05).Conclusion:According to the relevant literature included in this paper,the results of the surgical treatment of early cervical cancer suggests that the LRH group has a longer operation time and a higher requirement for the skill level,but it is more safe than the ARH group,and the short-term effect is more ideal.However,due to the limitations of the number and quality of the literature included in the study,whether the long-term effect of LRH group is better than that of the ARH group needs a higher quality and a large sample of RCT to be further confirmed.