Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
Department of Radiology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
J Gynecol Oncol. 2014 Apr;25(2):111-7. doi: 10.3802/jgo.2014.25.2.111. Epub 2014 Apr 9.
To investigate the surgical and oncological outcomes of laparoscopic surgery compared with laparotomy for the treatment of early-stage ovarian cancer.
Data from patients who underwent surgical management for early-stage ovarian cancer between 2006 and 2012 were retrospectively reviewed. All patients presented with stage I or II disease, and underwent comprehensive staging surgery consisting of a total hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy, omentectomy, and peritoneal cytology.
Seventy-seven patients who underwent laparoscopic surgery (24 patients) or laparotomy (53 patients) were identified. Surgery for none of the patients was converted from laparoscopy to laparotomy. The mean operation time was shorter and the estimated blood loss was lower in the laparoscopy group than in the laparotomy group, though the differences were not statistically significant (193 min vs. 224 min, p=0.127; 698 mL vs. 973 mL, p=0.127). There were no differences in the intraoperative or postoperative complications. During a mean follow-up period of 31 months, tumor recurrence occurred in 4 patients: 2 (8.3%) in the laparoscopy group and 2 (3.8%) in the laparotomy group. The mean disease-free survival was 59 months after laparoscopy and 66 months after laparotomy (p=0.367).
Laparoscopic surgery seems to be adequate and feasible for the treatment of early-stage ovarian cancer with comparable results to laparotomy in terms of the surgical outcomes and oncological safety.
探讨腹腔镜手术与开腹手术治疗早期卵巢癌的手术和肿瘤学结局。
回顾性分析 2006 年至 2012 年间接受手术治疗的早期卵巢癌患者的数据。所有患者均患有 I 期或 II 期疾病,并接受了全面分期手术,包括全子宫切除术、双侧输卵管卵巢切除术、盆腔和腹主动脉旁淋巴结切除术、网膜切除术和腹膜细胞学检查。
共确定了 77 例接受腹腔镜手术(24 例)或开腹手术(53 例)的患者。没有患者的手术从腹腔镜转为开腹。虽然差异无统计学意义(193 分钟比 224 分钟,p=0.127;698 毫升比 973 毫升,p=0.127),但腹腔镜组的手术时间更短,估计出血量更少。术中或术后并发症无差异。在平均 31 个月的随访期间,4 例患者出现肿瘤复发:腹腔镜组 2 例(8.3%),开腹组 2 例(3.8%)。腹腔镜组的无病生存率为 59 个月,开腹组为 66 个月(p=0.367)。
腹腔镜手术似乎足以治疗早期卵巢癌,并且在手术结果和肿瘤学安全性方面与开腹手术相当。