不同手术方式治疗Ia期子宫内膜样腺癌的临床疗效研究.pdfVIP

摘 要 摘 要 目的：探讨不同手术方式治疗Ia期子宫内膜样腺癌临床疗效及其术后并发症并加以 研究比较。以期为临床提供诊治依据，使患者得到更加合理的个体化治疗，提高患者生 存率及生存质量。 方法：回顾性分析2001年3月～2006年12月手术治疗的Ia期高分化子宫内膜样腺癌68 例。根据手术方式不同分组。其中行筋膜外全子宫加双附件切除术30例为I组，行筋膜 外全子宫加双附件切除术+盆腔淋巴结清扫术38例为II组。对两组的生存情况及围手术期 情况进行统计学分析并比较。 结果： Ⅰ组和Ⅱ组 5 年生存率分别为 96.6 ％、97.3 ％，两组比较差异无显著性 (P0 ．05) ；复发率分别为 3.33% 、2.63% 。两组比较差异无显著性(P0 ．05) 。手术时 间、术中出血量、住院时间、术后并发症发生率、生存质量、两组比较差异有统计学意 义(P0 ．05) 。淋巴结清扫对预后影响不明显。 结论：1. Ia 期子宫内膜样腺癌患者采用筋膜外全子宫加双附件切除术是可行的。 2. I期子宫内膜癌淋巴结切除可明确手术病理分期，评估预后。 3. 淋巴结清扫术本身不是Ia 期G1子宫内膜样腺癌的治疗手段，扩大手术范 围并不能显著提高患者的生存率。 关键词 子宫内膜癌 手术方式 比较研究 I Abstract Abstract Objective: The outcomes and postoperative complications with alternative surgical procedures for stage Ia endometrial cancer are discussed and compared here. This is to explore the clinical basis for reasonable individual treatment, to increase the survival rate, and to improve the quality of life. Methods: Sixty-eight postoperative cases with stage Ia endometrial carcinoma from March 2001 to December 2006 are reviewed and retrospectively analyzed. The patients were divided into two groups according to different surgical procedures performed. Thirty of them undergone extro-fascia total hysterectomy and adnexectomy are group I. The group II includes the rest 38 patients received additional pelvic lymphadenectomy as well as the same above procedures. The survival rates and peri-operative conditions in two groups are compared by statistical analysis. Results:The 5 year survival rat