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早期卵巢癌和输卵管癌的腹腔镜治疗:手术及生存结果

Laparoscopic management of early ovarian and fallopian tube cancers: surgical and survival outcome.

作者信息

Nezhat Farr R, Ezzati Mohammad, Chuang Linus, Shamshirsaz Alireza A, Rahaman Jamal, Gretz Herb

机构信息

Division of Gynecologic Oncology, Minimally Invasive Surgery and Gynecologic Robotics, Department of Obstetrics and Gynecology, St Luke's-Roosevelt Hospital Center, New York, NY 10019, USA.

出版信息

Am J Obstet Gynecol. 2009 Jan;200(1):83.e1-6. doi: 10.1016/j.ajog.2008.08.013. Epub 2008 Nov 18.

Abstract

OBJECTIVE

To evaluate the role of laparoscopy for staging of early ovarian cancers.

STUDY DESIGN

Case series conducted at the University Hospital with 36 patients who had presumed early-stage adnexal cancers. Laparoscopic staging/restaging was performed.

RESULTS

Cases included 20 invasive epithelial tumors, 11 borderline tumors, and 5 nonepithelial tumors. Mean number of peritoneal biopsies, paraaortic nodes, and pelvic nodes were 6, 12.23, and 14.84, respectively. Eighty-three percent of the patients had laparoscopic omentectomy. On final pathology, 7 patients were upstaged. Postoperative complications included 1 small bowel obstruction, 2 pelvic lymphoceles, and 1 lymphocele cyst. Mean duration of follow-up is 55.9 months. Three patients had recurrences. All patients are alive without evidence of the disease.

CONCLUSION

This represents 1 of the largest series and longest follow-ups of laparoscopic staging for early-stage adnexal tumors. Laparoscopic staging of these cancers appears to be feasible and comprehensive without compromising survival when performed by gynecologic oncologists experienced with advanced laparoscopy.

摘要

目的

评估腹腔镜检查在早期卵巢癌分期中的作用。

研究设计

在大学医院对36例疑似早期附件癌患者进行的病例系列研究。进行了腹腔镜分期/再分期。

结果

病例包括20例浸润性上皮肿瘤、11例交界性肿瘤和5例非上皮性肿瘤。腹膜活检、腹主动脉旁淋巴结和盆腔淋巴结的平均数量分别为6个、12.23个和14.84个。83%的患者接受了腹腔镜网膜切除术。最终病理检查显示,7例患者分期上调。术后并发症包括1例小肠梗阻、2例盆腔淋巴囊肿和1例淋巴囊肿。平均随访时间为55.9个月。3例患者复发。所有患者均存活,无疾病证据。

结论

这是最大系列的早期附件肿瘤腹腔镜分期研究之一,且随访时间最长。由经验丰富的妇科肿瘤学家进行腹腔镜手术时,这些癌症的腹腔镜分期似乎可行且全面,不会影响生存率。

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