原发性晚期卵巢癌的腹腔镜肿瘤细胞减灭术
Laparoscopic cytoreduction for primary advanced ovarian cancer.
作者信息
Fanning James, Hojat Rod, Johnson Jil, Fenton Bradford
机构信息
Summa Health System, Northeastern Ohio Universities College of Medicine, Akron, Ohio 44304, USA.
出版信息
JSLS. 2010 Jan-Mar;14(1):80-2. doi: 10.4293/108680810X12674612014707.
INTRODUCTION
We evaluated the feasibility of laparoscopic cytoreduction for primary advanced ovarian cancer.
METHODS
All patients with presumed stage 3/4 primary ovarian cancer underwent attempted laparoscopic cytoreduction. All patients had CT evidence of omental metastasis and ascites. A 5-port (5-mm) transperitoneal approach was used. A bilateral salpingo-oophorectomy, supracervical hysterectomy, and omentectomy were performed with PlasmaKinetic (PK) cutting forceps. A laparoscopic 5-mm Argon-Beam Coagulator was used to coagulate tumor in the pelvis, abdominal peritoneum, intestinal mesentery, and diaphragm.
RESULTS
Nine of 11 cases (82%) were successfully debulked laparoscopically without conversion to laparotomy. Median operative time was 2.5 hours, and median blood loss was 275 mL. All tumors were debulked to <2 cm and 45% had no residual disease. Stages were 1-3B, 7-3C, and 1-4. Median length of stay was one day. Median VAS pain score was 4 (discomforting). Two of 11 patients (18%) had postoperative complications.
CONCLUSION
Laparoscopic cytoreduction was successful and resulted in minimal morbidity. Because of our small sample size, additional studies are needed.
引言
我们评估了腹腔镜细胞减灭术治疗原发性晚期卵巢癌的可行性。
方法
所有疑似3/4期原发性卵巢癌患者均尝试接受了腹腔镜细胞减灭术。所有患者均有CT证据显示存在大网膜转移和腹水。采用五孔（5毫米）经腹入路。使用等离子动力（PK）钳进行双侧输卵管卵巢切除术、次全子宫切除术和大网膜切除术。使用腹腔镜5毫米氩束凝固器对盆腔、腹腔腹膜、肠系膜和膈肌的肿瘤进行凝固。
结果
11例患者中有9例（82%）成功通过腹腔镜实现肿瘤细胞减灭，未中转开腹。中位手术时间为2.5小时，中位失血量为275毫升。所有肿瘤均减灭至<2厘米，45%的患者无残留病灶。分期为1-3B、7-3C和1-4。中位住院时间为1天。中位视觉模拟评分（VAS）疼痛评分为4分（不适）。11例患者中有2例（18%）出现术后并发症。
结论
腹腔镜细胞减灭术取得成功，且发病率极低。由于我们的样本量较小，因此需要进一步研究。
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