Pennsylvania State University, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hershey, PA 17033, United States.
Gynecol Oncol. 2011 Oct;123(1):47-9. doi: 10.1016/j.ygyno.2011.06.020. Epub 2011 Jul 7.
The purpose of this paper is to evaluate laparoscopic-assisted cytoreduction for primary advanced ovarian cancer: feasibility, morbidity, response to chemotherapy and survival.
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 five port (5-mm) transperitoneal approach was used. A bilateral salpingo-oophorectomy, supracervical hysterectomy and omentectomy were performed with the 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.
Twenty-three cases (92%) were successfully cytoreduced laparoscopically without conversion to laparotomy. Median operative time was 2.3h and median blood loss was 340 cc. All tumors were debulked to less than 2 cm and 36% had no residual disease. Median length of stay was 1 day. Median VAS pain score was 4-discomforting. Six patients (24%) had post-operative complications, none grades 3-4. Median overall survival is 3.5 years.
Laparoscopic-assisted cytoreduction for primary advanced ovarian cancer was successful, resulting in minimal morbidity, and acceptable survival.
本文旨在评估腹腔镜辅助减瘤术治疗原发性晚期卵巢癌的可行性、发病率、化疗反应和生存率。
所有疑似 3/4 期原发性卵巢癌的患者均接受腹腔镜辅助减瘤术尝试。所有患者均有 CT 腹膜转移和腹水的证据。采用五孔（5mm）经腹腔入路。使用等离子双极电切剪行双侧输卵管卵巢切除术、子宫次全切除术和大网膜切除术。腹腔镜 5mm 氩气束凝固器用于凝固盆腔、腹腔腹膜、肠肠系膜和膈肌的肿瘤。
23 例（92%）患者成功地完成了腹腔镜下的肿瘤细胞减灭术，无中转开腹。中位手术时间为 2.3 小时，中位出血量为 340cc。所有肿瘤均减瘤至小于 2cm，36%无残留病灶。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）。6 例（24%）患者发生术后并发症，均为 1-2 级。中位总生存时间为 3.5 年。
腹腔镜辅助减瘤术治疗原发性晚期卵巢癌是成功的，发病率低，生存情况可接受。
