系统性淋巴结清扫术对子宫内膜癌患者预后的影响及安全性分析*

目的:分析系统性淋巴结清扫术对子宫内膜癌患者预后的影响及安全性。方法:选择2010年6月~2012年6月我院收治的68例子宫内膜癌患者作为研究对象,将其随机分为研究组与对照组。对照组行两侧附件+全子宫切除+盆腔淋巴结清扫术,研究组行两侧附件+全子宫切除+系统性腹腔、盆腔主动脉旁淋巴结清扫术。观察和比较两组患者术后3年内的生存率、疾病复发转移率以及并发症的发生率。结果:研究组检出阳性淋巴结15枚,发现4例患者淋巴结转移;对照组患检出阳性淋巴结3枚,发现1例患者淋巴结转移。两组阳性淋巴结检出率及淋巴结转移发现率比较差异无统计学意义(P0.05)。研究组3年内生存率为88.24%,显著高于对照组的67.65%(P0.05);复发转移率为14.71%,显著高于对照组的35.29%(P0.05)。研究组患者术后发生不全性肠梗阻发生率为17.65%,显著高于对照组(P0.05);但两组术后下肢水肿、深静脉血栓、淋巴囊肿、输尿管尿瘘、体温转复时间5 d的发生率对比差异均无统计学意义(P0.05)。结论:系统性淋巴结清扫术可以延长子宫内膜癌患者的3年生存率,降低病灶的复发及转移率,虽然术后不全性肠梗阻的发生率有所增加,但仍在可控范围内。

The Influence of Systemic Lymph Node Dissection on the Prognosis of Patients with Endometrial Carcinoma and Its Safety

Objective:To analyze the safety and effect of systematic lymph node dissection on patients with endometrial carcinoma.Methods:68 patients with endometrial cancer who were treated in our hospital from June 2010 to June 2012 were randomly divided into the study group and the control group. The control group was treated with two sides, the total hysterectomy plus pelvic lymph node dissection, and the study group was treated with two sides of the appendix, the total hysterectomy plus systemic abdominal cavity, pelvic aortic dissection. The survival rate, recurrence and metastasis rate and the incidence of complications in two groups of patients 3 years after operation were observed and compared between two groups.Results:Positive lymph nodes were detected in the study group, 4 cases of lymph node metastasis, 3 cases of control group, 1 cases of patient with lymph node metastasis. No statistically significant difference was observed in the positive rate of lymph node and the detection rate of lymph node metastasis between two groups(P>0.05). The 3-year survival rate in study group was 88.24%, which was significantly higher than 67.65%in the control group (P<0.05). The recurrence rate in the study group was 14.71%, which was significantly higher than 35.29%in the control group (P<0.05). The postoperative incidence of incomplete intestinal obstruction patients in the study group was 17.65%, it was higher than the control group (P<0.05), but no significant difference was found in the incidence of postoperative lower extremity edema, deep vein thrombosis, lymphocele, ureteral fistula, body turn complex time> 5d (P>0.05).Conclusion:Systemic lymph node dissection could prolong the 3-year survival rate of patients with endometrial cancer, reduce the recurrence and metastasis rate, although the probability of postoperative incomplete intestinal obstruction had increased, but still in the controllable range.