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目的:比较腹腔镜和开腹手术在卵巢癌二次探查术中的应用效果和安全性。方法:选择2012年1月至2015年10月于我院就诊的卵巢癌患者58例,根据二次探查术的方式分成两组,腹腔镜组(28例)和开腹手术组(30例),观察比较两组患者手术时间、术中出血量、肛门首次排气时间、并发症发生率及二次探查的阳性率。对两组患者进行随访,比较两组患者二探术后的复发率及生存时间。结果:腹腔镜组肛门首次排气时间明显短于开腹组患者,术中出血量也均明显少于开腹组患者,具有非常显著性差异(P<0.05),而两组的手术时间、并发症发生率和二探阳性率相近,两组之间比较,差异无统计学意义(P>0.05)。二次探查术阳性和二次探查术阴性的患者中,腹腔镜组和开腹组的中位生存时间比较,差异无显著性(P>0.05)。二次探查术阴性的患者中,腹腔镜组和开腹组患者随访期间的复发率比较,差异也无显著性(P>0.05)。结论:腹腔镜二次探查术具有创伤小、并发症少、患者恢复快、患者易于接受等微创优势,且能取得与开腹二次探查术相当的安全性和准确性,可以作为卵巢癌二次探查术的手段之一。
Objective: To compare the effectiveness and safety of laparoscopic and open surgery in secondary exploration of ovarian cancer. Methods: Fifty-eight patients with ovarian cancer who were treated in our hospital from January 2012 to October 2015 were divided into two groups according to the method of second exploration: laparoscopic group (28 cases) and open surgery group (30 cases) The operation time, intraoperative blood loss, time of the first defecation of anus, complication rate and the positive rate of secondary exploration were observed and compared between the two groups. The two groups of patients were followed up, the recurrence rate and survival time of two groups were compared. Results: The time of the first laparoscopic anus evacuation was significantly shorter than that of the open group, and the amount of bleeding during operation was also significantly less than that of the laparotomy group (P <0.05). However, the operative time, The incidence of complications was similar to the positive rate of second exploration. There was no significant difference between the two groups (P> 0.05). There was no significant difference in the median survival time between laparoscopic and open laparotomy patients (P> 0.05). There was no significant difference in the relapse rate between laparoscopic group and open group in secondary exploration-negative patients (P> 0.05). Conclusions: Laparoscopic second exploration has the advantages of less trauma, fewer complications, faster recovery of patients, easier for patients to accept and other minimally invasive advantages, and can achieve the safety and accuracy equivalent to open exploration twice, which can be used as ovarian cancer One of the means of secondary exploration.