Al-Asari Sami, Abduljabbar Alaa
Department of colorectal surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Ann Surg Innov Res. 2012 Sep 17;6(1):9. doi: 10.1186/1750-1164-6-9.
Infertility due to pelvic radiation for advanced rectal cancer treatment is a major concern particularly in young patients. Pre-radiation laparoscopic ovarian transposition may offer preservation of ovarian function during the treatment however its use is limited.
The study investigates the safety, feasibility and effectiveness of pre-radiation laparoscopic ovarian transposition and its effect on ovarian function in the treatment o locally advanced rectal cancer.
Charts review of all young female patients diagnosed with locally advanced rectal cancer, underwent laparoscopic ovarian transposition, then received preoperative radiotherapy at king Faisal Specialist Hospital and Research Centre between 2003-2007.
During the period studied three single patients age between 21-27 years underwent pre-radiation laparoscopic ovarian transposition for advanced rectal cancer. All required pretreatment laparoscopic diversion stoma due to rectal stricture secondary to tumor that was performed at the same time. One patient died of metastatic disease during treatment. The ovarian hormonal levels (FSH and LH) were normal in two patients. One has had normal menstrual period and other had amenorrhoea after 4 months follow-up however her ovarian hormonal level were within normal limits.
Laparoscopic ovarian transposition before pelvic radiation in advanced rectal cancer treatment is an effective and feasible way of preservation of ovarian function in young patients at risk of radiotherapy induced ovarian failure. However, this procedure is still under used and it is advisable to discuss and propose it to suitable patients.
因晚期直肠癌治疗进行盆腔放疗导致的不孕是一个主要问题，尤其在年轻患者中。放疗前腹腔镜下卵巢移位术在治疗期间可能有助于保留卵巢功能，但其应用有限。
本研究探讨放疗前腹腔镜下卵巢移位术治疗局部晚期直肠癌的安全性、可行性和有效性及其对卵巢功能的影响。
回顾2003年至2007年间在法赫德国王专科医院和研究中心诊断为局部晚期直肠癌并接受腹腔镜下卵巢移位术，随后接受术前放疗的所有年轻女性患者的病历。
在研究期间，3例年龄在21至27岁之间的单身患者因晚期直肠癌接受了放疗前腹腔镜下卵巢移位术。由于肿瘤继发直肠狭窄，所有患者均需要在术前进行腹腔镜转流造口术，该手术与卵巢移位术同时进行。1例患者在治疗期间死于转移性疾病。2例患者的卵巢激素水平（促卵泡生成素和促黄体生成素）正常。1例患者月经正常，另1例患者在随访4个月后闭经，但其卵巢激素水平在正常范围内。
晚期直肠癌治疗中，盆腔放疗前进行腹腔镜下卵巢移位术是一种在有放疗导致卵巢功能衰竭风险的年轻患者中保留卵巢功能的有效且可行的方法。然而，该手术的应用仍然不足，建议与合适的患者讨论并推荐该手术。
