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I期卵巢癌患者腹腔镜分期手术的手术及生存结局

Surgical and survival outcomes of laparoscopic staging surgery for patients with stage I ovarian cancer.

作者信息

Lee Chyi-Long, Kusunoki Soshi, Huang Chen-Yin, Wu Kai-Yun, Lee Pei-Shan, Huang Kuan-Gen

机构信息

Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital Keelung, Taiwan; Chang Gung University College of Medicine, Kweishan, Taoyuan, Taiwan.

Department of Obstetrics and Gynecology, Faculty of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, 113-8431, Japan.

出版信息

Taiwan J Obstet Gynecol. 2018 Feb;57(1):7-12. doi: 10.1016/j.tjog.2017.12.002.

Abstract

OBJECTIVE

To assess the feasibility and survival outcomes of laparoscopic staging for patients with stage I ovarian cancer.

MATERIALS AND METHODS

Consecutive patients who underwent laparoscopic staging surgery for stage I ovarian cancer from January 2002 to December 2014 were evaluated retrospectively by chart review.

RESULTS

Twenty-four patients with mean age 43.9 ± 9.9 years and mean body mass index 24.0 ± 3.8 kg/m were included, in which 12 (50%) patients were in stage IA and 12 (50%) in stage IC. The histological types included serous in 6 (25%), mucinous in 7 (29.1%), endometrioid in 6 (25%), clear cell in 5 (20.8%) patients. The mean surgical time was 306.4 ± 98.5 min, and the mean blood loss was 204.2 ± 188.6 mL. None of the patients required conversion to laparotomy. The median numbers of resected pelvic and para-aortic lymph nodes were 20 and 4, respectively. One (4.1%) patient encountered bowel injury intraoperatively, and the other 1 (4.1%) patient hydronephrosis postoperatively. The overall survival rate was 95% in the current series in a median follow-up of 31.5 months.

CONCLUSION

Laparoscopic staging surgery performed for early stage ovarian cancer has better long term survival outcomes than the literature report. Laparoscopic treatment by a trained gynecologic oncologist is an ideal alternative for early stage ovarian cancer with the advantage of minimal invasiveness.

摘要

目的

评估腹腔镜分期手术用于Ⅰ期卵巢癌患者的可行性及生存结局。

材料与方法

回顾性分析2002年1月至2014年12月期间接受腹腔镜分期手术的Ⅰ期卵巢癌连续患者的病历资料。

结果

纳入24例患者,平均年龄43.9±9.9岁,平均体重指数24.0±3.8kg/m²,其中12例(50%)为ⅠA期,12例(50%)为ⅠC期。组织学类型包括浆液性6例(25%)、黏液性7例(29.1%)、子宫内膜样6例(25%)、透明细胞5例(20.8%)。平均手术时间为306.4±98.5分钟,平均失血量为204.2±188.6毫升。所有患者均无需中转开腹。盆腔和腹主动脉旁淋巴结切除中位数分别为20个和4个。1例(4.1%)患者术中发生肠损伤,另1例(4.1%)患者术后发生肾积水。本系列患者中位随访31.5个月,总生存率为95%。

结论

早期卵巢癌腹腔镜分期手术的长期生存结局优于文献报道。由训练有素的妇科肿瘤学家进行腹腔镜治疗是早期卵巢癌的理想选择,具有微创优势。

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