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卵巢癌肝膈间转移的外科治疗:83例报告

[The surgical treatment of ovarian cancer metastasis between liver and diaphragm: a report of 83 cases].

作者信息

Xu Y Y, Lu X, Mao Y L, Xiong J P, Bian J, Huang H C, Yang H Y, Sang X T, Zhao H T, Xu H F, Chi T Y, Du S D, Zhong S X, Huang J F

机构信息

Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2017 Nov 1;55(11):838-841. doi: 10.3760/cma.j.issn.0529-5815.2017.11.004.

Abstract

To explore the safety and feasibility of associating diaphragm resection and liver-diaphragmatic metastasis lesions resection for patients with advanced ovarian cancer. Retrospectively analysis 83 cases(98 times) of advanced ovarian cancer with liver-diaphragmatic metastasis between January 2012 and December 2016 at Department of Liver Surgery, Peking Union Medical College Hospital.The patients were aged from 19 to 75 years.Surgical procedure included metastatic lesions resection(43 times) and stripping(55 times). Operation status, post-operative complications, pathology results and follow-up of the patients were analyzed. Fifteen patients received twice surgical treatment and 68 patients received one time surgical treatment. Postoperative hemorrhage in chest and between liver and diaphragm was not occurred in all cases.Dyspnea and low oxygen saturation were occurred in two cases of stripping patients and 1 case of metastatic lesions resection patients.Results of CT examination indicated that there was medium to large amount of ascites in right chests.The symptoms were relieved after placing thoracic closed drainage.Other patients were recovered smoothly.All patients were diagnosed as ovarian cancer by pathological examination. Associating diaphragm resection is safe and feasible for liver-diaphragmatic metastasis lesions from ovarian cancer.

摘要

探讨晚期卵巢癌患者行膈肌切除术联合肝膈转移灶切除术的安全性和可行性。回顾性分析2012年1月至2016年12月在北京协和医院肝脏外科收治的83例(98次)伴有肝膈转移的晚期卵巢癌患者。患者年龄19至75岁。手术方式包括转移灶切除术(43次)和剥除术(55次)。分析患者的手术情况、术后并发症、病理结果及随访情况。15例患者接受了两次手术治疗,68例患者接受了一次手术治疗。所有病例均未发生术后胸腔及肝膈间出血。剥除术患者中有2例、转移灶切除术患者中有1例出现呼吸困难和低氧饱和度。CT检查结果显示右胸腔有中至大量腹水。放置胸腔闭式引流后症状缓解。其他患者恢复顺利。所有患者经病理检查均诊断为卵巢癌。对于卵巢癌肝膈转移灶,联合膈肌切除术是安全可行的。

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