Comparative Curative Effect Analysis Of Laparoscopic Surgery And Laparotomy For Cervical Cancer With Extensive Complete Hysterectomy And Pelvic Lymphadenectomy

Objective: To comparative of laparoscopic radical hysterectomy (LRH) andabdominal radical hysterectomy (ARH) for IA-ⅡB-stage cervical cancer Clinical curativeeffect.Methods:We performed a retrospect review of all patient who underwent laparoscopicand laparotomic radical hysterectonry at our hospital between March2000and December2011,200patients with cervical carcinoma were reviewed,65of whom underwent RAH and135of who were tread by LRH.The operative parameters including Preoperative basicsituation,operative time, intraoperative blood loss,intraoperative urine, intraoperativetransfusion volume, hospitalization days, the urine tube retention days, the urine tuberetention days, after the preoperative hemoglobin change, residual urine volume, analexhaust time, postoperative begin activities time, intraoperative blood transfusion cases,postoperative analgesia drug use cases, lymph node number of operation, intraoperative andpostoperative complications (including intraoperative complications, recent complications:ureteral injury, bowel、bladder injury, lymphocele, incision infection、 liquefaction, urineretention, intestinal obstruction, lower extremity venous thrombosis, ureter fistula, bladdervagina fistula; postoperative long-term complications: rectal dysfunction, bladderdysfunction), death; Surgery prognosis and postoperative quality of life.Results:1. Two groups of cases of preoperative clinical indicators (including age,weight, preoperative clinical staging, pathological type) there was no statistically significantdifference (P>0.05);2. LRH and ARH groups operation time, intraoperative blood loss,postoperative fever days and transfusion volume, hospitalization days, the urine tuberetention days, preoperative hemoglobin after change, residual urine volume, anal exhausttime, postoperative bed activity time, intraoperative blood transfusion, the number of cases,postoperative analgesia drug use, remove the lymph node number difference wasstatistically significant (P <0.05or P <0.01); the two groups intraoperative urinary volumehas no statistical significance (P>0.05);3. recent complications in LRH group a total of24cases,41cases of ARH (the same patient may merge multiple complications) at the sametime, the two groups was statistically significant difference (P <0.05); Complications ofbowel injury, infection of incision and incision liquefied, secondary suture of incision,intestinal obstruction, venous thrombosis, vaginal stump recurrence in two groups wasstatistically significant difference (P <0.05); Two groups had no incision transplantation,long-term complications of laparoscopic group1,0cases of abdominal group; In the twogroups of urinary retention, urinary bladder, ureteral injury, damage, bladder, ureteral fistula vaginal fistula, lymph node biopsy is positive, a positive specimens cut edge of tumor,lymphatic cyst comparison there was no statistically significant difference (P>0.05);4. Thepostoperative survival analysis due to the two groups lost to follow-up rate is higher tostatistical analysis.Conclusion:1. Laparoscopic surgery in the treatment of gynecologic malignanttumors with small trauma, less bleeding, Quicker recovery of gastrointestinal function，intestinal obstruction, infection of incision or liquefaction, Postoperative analgesia druguse.Intraoperative urinary volume, urinary retention, ureter fistula, bladder, ureteral injuryvaginal fistula, lymph node biopsy is positive, a positive specimens cut edge of tumor andlymph cyst formation in the two groups have no difference.2. Laparoscopic group, thenumber of the lymph node surgery than laparotomy group under the guarantee the safety ofthe operation effect is superior to laparotomy surgery.3. Laparoscopy and laparotomy groupof postoperative quality of life: physical condition and mental state assessment of the good,the fun of life, and the negative effects in social functions...