Short-term and Long-term Therapeutic Effects of Laparoscopic Surgery with Different Approaches for Endometrial Cancer

Wu Wenya

doi:10.3969/j.issn.1004-5775.2025.10.004

Abstract：Objective:To analyze the short-term and long-term efficacy of laparoscopic surgery using different approaches for the treatment of endometrial cancer.Methods:Data of 94 patients with endometrial cancer who underwent laparoscopic surgery in Department of Gynecology of the hospital from January 2019 to November 2021 were collected.According to the laparoscopic approach,they were divided into Group A(47 cases through the transperitoneal approach)and Group B(47 cases through the extraperitoneal approach).Both groups were followed up for 2 years after surgery.Perioperative indicators(surgical time,intraoperative blood loss,number of lymph node resections(adjacent to the abdominal aorta),drainage tube removal time,hospital stay),immune function(CD3+,CD4+,CD8+,CD4+/CD8+),tumor markers[carbohydrate antigen 125(CA125),human epididymal protein 4(HE4)]levels,postoperative complications and survival were compared between two groups.Results:The surgical time,drainage tube removal time and hospital stay in Group B were shorter than those in Group A,with more intraoperative bleeding and lymph node dissection compared to Group A(t=7.934,4.047,13.062,5.560,14.326;P＜0.05).After surgery,the levels of CD3+,CD4+and CD4+/CD8+in both groups decreased compared to before surgery,while the levels of CD8+increased(t=3.210,4.897,6.158,3.162;P＜0.05).After surgery,serum tumor marker levels were decreased in both groups,and the difference was statistically significant(t=1.263,0.882;P＜0.05).The total complication rate of group B was lower than that of group A,and the difference was statistically significant(χ2=6.114,P＜0.05).All patients completed 2 years of follow-up,with a median follow-up of 13 months.Relapse-free survival and overall survival in group B were higher than those in group A,and the difference was statistically significant(χ2=4.285,4.366;P＜0.05).Conclusion:Laparoscopic surgery with different approaches has similar improvement effects on serum tumor markers in patients with endometrial cancer.Compared to the transperitoneal approach,the extraperitoneal approach has the characteristics of fast postoperative recovery,thorough lymph node dissection,and fewer postoperative complications.Moreover,it causes less damage to the patient's immune function and has a better long-term survival rate.However,the extraperitoneal approach also has the problem of high intraoperative bleeding.