Clinical Analysis Of Laparoscopic And Abdominal Hysterectomy In The Treatment Of Endometrial Carcinoma

Objective: To investigate the safety, feasibility and clinical application value of laparoscopic hysterectomy in the treatment of endometrial carcinoma.Methods: 210 patients with endometrial carcinoma admitted to our hospital from January 2000 to October 2013 were reviewed and divided into laparoscopic group(LH, n=160) and abdominal group(AH, n=50). summarized and analyzed the general information, the operative parameters including operation time, intraoperative blood loss, Intraoperative urinary volume, Intraoperative infusion volume, lymph nodes number retrieved, postoperative drainage tube keeping days, postoperative anal exhaust time, postoperative fever days, catheterization days, abdominal suture removal time, postoperative hospital stays,intraoperative and postoperative complications,recurrence rate and mortality, postoperative quality of life.Results:1. Between the two groups, the preoperative clinical indicators(including age, MBI, times of gestation and delivery, years of menstruation, cases of pausimenia, previous abdominal surgery, related complications: hypertension, diabetes.etc) there was no statistically significant difference(P > 0.05).2. The comparison of postoperative pathological information between the two groups(including the pathological staging, grade, type), there was no statistically significant difference(P > 0.05).3. The mean operation time was(162.0±42.0)min in laparoscopic group and(195.2±47.9)min in abdominal group, the difference between the two groups was statistically significant(P<0.05). The mean intraoperative blood loss of laparoscopic group was(172.4±105.3)ml, which was less than(365.0±185.9)ml of abdominal group obviously(P<0.05). The mean lymph nodes number retrieved in laparoscopic group was(19.15±8.13),which showed a significant difference from(13.03±6.75) in abdominal group(P<0.05). The mean postoperative anal exhaust time in laparoscopic group was(2.0±0.6)days, which was different from(2.5±0.5)days in abdominal group(P<0.05).4.The incidences of ureteral injury, Intraoperative transfusion, intestinal obstruction, wound dehiscence and urinary tract infection in laparoscopic group were lower than that in abdominal group(P<0.05).the differences of other complications’ incidences, recurrence rate and mortality in two groups had no statistical significance.( P>0.05).5. Follow-up results: the recurrence rate and mortality similar between the two groups had no statistical significance(P>0.05). According to QOL-UCC quality of life questionnaire, the postoperative quality of life differences of the two groups of patients had no statistical significance(P > 0.05)Conclusion:1. Compared with abdominal group study, laparoscopic treatment of endometrial cancer has less intraoperative bleeding, shorter operation time, high lymph node clearance, quicker recovery of gastrointestinal function, low recurrent rate, and remove the early time, the advantages of shorter postoperative hospital stay; in the aspect of ureteral injury, intraoperative blood transfusion, intestinal obstruction, incision dehiscence, the incidence of urinary tract infection and other complications, laparoscopic group was lower, which shows that laparoscopic hysterectomy in the treatment of endometrial carcinoma has effectiveness, safety, thoroughness and feasibility.2. Compared with abdominal group, Laparoscopic group had no difference in the aspect of postoperative recurrence rate and mortality, the postoperative quality of life.3. In the treatment of endometrial carcinoma, the laparoscopic hysterectomy still had some controversies in the international, need a large number of multicenter prospective, randomized, controlled trial to confirm.