Clinical Comparative Analysis Of Laparoscopic Surgery And Trans-abdominal Surgery For Women With Early Cervical Cancer

Objective:To compare the peri-operative and post operative indexes of patients who underwent laparoscopic or trans-abdominal cervical radical hysterectomy.Methods:This research retrospectively analyzed clinical information from 160 patients who had radical hysterectomy from Jan.2013 to Nov.2016 in our gynecology department of the First Hospital of China Medical University.Among them,56 cases underwent laparoscopic surgery(laparoscopy group),and 104 cases underwent trans-abdominal surgery(laparotomy group).The indexes,which were analyzed and compared the pros and cons,include preoperative indexes(age,weight,pathological type,HPV infection,preoperative radiotherapy or chemotherapy),perioperative indexes(preoperative and postoperative hemoglobin,rate of transfusion,amounts of massive hemorrhage,duration of surgery,numbers of lymph nodes and incidence of intestinal and urinary injury)and postoperative indexes[incidence of postoperative complications(urinary retention,ileus,lymphocyst,deep vein thrombosis,pneumothorax,gas embolism and abnormal healing),hospitalization period and expenses].Results:(1)The hemoglobin value between preoperative and postoperative of laparoscopy group(12.30 ± 5.94g/L vs 16.80 ± 14.89g/L,P=0.008);the amount of transfusion(35/104 vs 8/56,P<0.05).Blood loss over 800 ml occured in only 1 patient in laparoscopy group and 2 in laparotomy group,(P=0.951).(2)The duration of surgery(227.39 + 51.20 vs 212.78 + 54.2,P=0.099).(3)The number of lymph nodes(27.71 + 8.24 vs 30.13 + 12.146,P=0.186).(4)Only 1 patient in laparoscopy group appeared ureter injury,and both groups didn't appear intestine injury.(5)The hospitalization expenses(30588.64 + 6019.16 vs 25199.44 + 4560.48,P=0.001);(6)The hospitalization period(11.55±3.05 vs 13.21±4.29,P=0.011).(6)The incidence of postoperative complications[7(0.13)vs 18(0.11),P=0.424].Among them,4(0.07)patients appeared urinary retention in laparoscopy group and 11(0.11)in laparotomy group(P=0.477),and 1(0.02)in laparoscopy group appeared intestinal obstruction while 3(0.03)appeared in laparotomy group(P=0.671).Both groups had 2patients presented lymphocyst(0.04 vs 0.02,P=0.524).2(0.02)in laparotomy group occured abnormal healing,while none in laparoscopy group(P=1.0).Deep vein thrombosis,pneumothorax,and gas embolism did not appeared in all patients.Conclusion:(1)Laparoscopic cervical radical hysterectomy has superiority in decreasing bleeding volume,rate of transfusion and hospitalization period.(2)Laparoscopic surgery is equal with trans-abdominal sugery in safety and efficacy,especially in duration of surgery,numbers of lymph nodes,perioperative and postoperative complications.(3)Laparoscopic surgery is at a greater disadvantage in hospitalization expenses.