The effect of laparoscopic surgery on the stress response and complication in patients with early ovarian cancer

ZHANG Wenfang; LIU Xunbi.

Abstract：investigate the effect of laparoscopic cytoreductive surgery on the stress response and complication in patients with early ovarian cancer. Methods From December 2015 to December 2017,120 patients with early ovarian cancer were enrolled in this study, and they were randomly divided into laparoscopic group and open surgery group with 60 cases in each group. Open surgery group was given open cytoreductive surgery, and laparoscope group was given laparoscopic cytoreductive surgery. Paclita?xel and carboplatin regimen was given 3?6 cycles after surgery. The stress response [ cortisol ( COR), adrenocorticotropic hormone (ACTH), adrenaline (E)], complications, perioperative period and recurrence after surgery were compared between the two groups. Results The intraoperative bleeding volume, exhaust time, active time after surgery and hospitalization time in laparoscopic group were (394. 52±45. 61)ml, (2. 08±0. 36) d, (2. 91± 0. 48) d and ( 13. 24± 1. 67) d, significantly lower than ( 472. 42± 50. 27) ml, (2. 67±0. 39)d, (3. 84±0. 52) d and (16. 51±2. 04) d in open surgery group, and the differences were statistically significant ( P＜0. 05). There were no significant difference in operation time and lymph node dissection between laparoscope group and open surgery group (P＞0. 05). The COR, ACTH and E after surgery were significantly higher than those before surgery ( P＜0. 05). COR, ACTH and E in laparoscope group were (287. 11±40. 12)nmol／L, (14. 02±1. 54)pmol／L and (42. 11±4. 92)pmol／L after surgery, signifi?cantly lower than(337. 13±45. 43)nmol／L, (15. 71±1. 68)pmol／L and (51. 42±5. 57)pmol／L in open surgery group, and the differ?ences were statistically significant (P＜0. 05). The common complications included incision infection, pulmonary infection, urinary re? tention and urinary incontinence, and the complication incidence of laparoscope group was 6. 7%, lower than 20. 0% of open surgery group (P＝0. 032). The 1?year recurrence rate in open surgery group was 5. 0%, higher than 3. 3% in laparoscope group, but the difference was not significant between the two groups(P＝0. 648). Conclusion Laparoscopic cytoreductive surgery is effective in the treatment of early ovarian cancer, which can effectively reduce the stress reaction and complications of patients and facilitate patients’ recovery, is worth for further clinical promotion.