Emin L, Meeus P, Beurrier F, Ferraioli D, Carrabin N, Ray-Coquard I, Treilleux I, Chopin N
Département de chirurgie oncologique, centre de lutte contre le cancer Lyon et Rhône-Alpes, 28, rue Laennec, 69373 Lyon cedex 08, France.
Département de chirurgie oncologique, centre de lutte contre le cancer Lyon et Rhône-Alpes, 28, rue Laennec, 69373 Lyon cedex 08, France.
Gynecol Obstet Fertil. 2015 May;43(5):342-7. doi: 10.1016/j.gyobfe.2015.03.006. Epub 2015 Apr 18.
Complication and survival analysis of cytoreduction surgery with modified posterior pelvic exenteration in the surgical treatment of the ovarian malignant tumor.
A retrospective monocentric study between 2000 and 2013 in Rhone-Alpes cancer treatment center. One hundred and fifty-two patients with ovarian cancer and treated by surgery with modified posterior pelvic exenteration were included. Complication in the 30 days after surgery was analysed by the Clavien-Dindo classification.
In our study, rate of global complication was 62.5% with a morbidity rate of grave complication of 7.9%. Our rate of complete resection was 82.2%. Three fistulas (2.2%) were found. On average, there was 6.6±1.8 (2-11) surgery gesture associated with Hudson resection during surgery. In univariate analysis, there was a statistic significant association between complication from the rank II of Clavien-Dindo classification and supraradical surgery, post-chemotherapy surgery, recurrent surgery, the resection of a diaphragmatic dome, and the partial gastric resection. This association was also observed with the number of surgical gesture associated with Hudson resection.
The main prognostic surgical factor in ovarian cancer is to obtain a no macroscopic residual disease. The modified posterior pelvic exenteration allowed to obtain it. Our study demonstrates a low rate of grave complication further to this type of surgery.
分析改良后盆腔脏器清除术在卵巢恶性肿瘤手术治疗中的并发症及生存情况。
对2000年至2013年在罗纳-阿尔卑斯癌症治疗中心进行的一项回顾性单中心研究。纳入152例行改良后盆腔脏器清除术治疗的卵巢癌患者。采用Clavien-Dindo分类法分析术后30天内的并发症。
在我们的研究中，总体并发症发生率为62.5%，严重并发症发生率为7.9%。完全切除率为82.2%。发现3例瘘（2.2%）。手术中与哈德逊切除术相关的平均手术操作次数为6.6±1.8（2 - 11次）。单因素分析显示，Clavien-Dindo分类Ⅱ级并发症与超根治性手术、化疗后手术、复发性手术、膈肌穹窿切除及部分胃切除之间存在统计学显著关联。这种关联在与哈德逊切除术相关的手术操作次数上也有体现。
卵巢癌手术的主要预后因素是实现无肉眼可见残留病灶。改良后盆腔脏器清除术能够实现这一点。我们的研究表明，此类手术后严重并发症发生率较低。
