腹腔镜手术对妇科恶性肿瘤患者腹膜TNF-α的影响-临床医学 妇产科学专业论文.docxVIP

上海交通大学医学院硕士学位论文 上海交通大学医学院硕士学位论文 THE EXPRESSION OF TNF-α IN THE PERITONEUM FROM HUMAN WITH CANCER GYNECOLOGICAL TREATED BY LAPAROSCOPIC OPERATION ABSTRACT Object The laparoscopic approach to surgery of the alimentary tract is now well accepted for appropriate procedures. Patients undergoing minimally invasive abdominal surgery benefit from less postoperative pain, shorter postoperative ileus, shorterhospital stays, a more rapid return to preoperative activity, and superior cosmesis compared with their laparotomized counterparts. Materials and methods From September 2006 to September 2008，60 women, were divided into 4 groups :25 women, with cancer(tumor malignant including cancer of the cervix, ovarian cancer, endometrial cancer),treated by laparoscopic approach,15 women with cancer(tumor malignant including cancer of the cervix, ovarian cancer, endometrial cancer),treated by open operation,10 women with hysteromyoma treated by laparoscopic approach,10 women with hysteromyoma treated by open operation. Results The expression of TNF-αin the peritoneum in the tumor malignant groups is obviously higher than that of the hysteromyoma group( P 0. 05). The expression of TNF-α in laparoscopic group were significantly lower than that in open group ( P 0. 05) . In laparoscopic tumor malignant group, the expression of TNF-αnear port site/incision were significantly higher than that far away from port site/incision ( P 0. 05), Comparison of the expression of TNF- α at various time points and positions showed no differences ( P 0. 05) . In open group, there were no significant difference of the expression of TNF-α at various time points and positive. Conclusions Carbon dioxide pneumoperitoneum used in laparoscopic surgery depress the expression of TNF-αof peritoneal mesothelial cells as compared with that of open surgery, which suggested that carbon dioxide pneumoperitoneum may increase the risk of tumor spread in laparoscopic gynecologic caner surgery. In laparoscopic g