阑尾肿瘤腹膜转移患者的全盆腔脏器切除术。2例病例系列报道。
Total pelvic exenterative surgery in patients with peritoneal metastases from appendiceal neoplasms. A case series of 2 patients.
作者信息
Sugarbaker Paul H
机构信息
Program in Peritoneal Surface Malignancies, MedStar Washington Hospital Center, 106 Irving St., NW, Suite 3900, Washington, DC, 20010, USA.
出版信息
Int J Surg Case Rep. 2019;65:279-283. doi: 10.1016/j.ijscr.2019.10.064. Epub 2019 Nov 5.
BACKGROUND
Surgery which includes peritonectomy, visceral resections, and perioperative chemotherapy has been used extensively to treat peritoneal metastases from appendiceal mucinous adenocarcinoma. The results of treatment vary with the grade of the neoplasm, the extent of abdominal and pelvic disease and the completeness of tumor removal.
METHODS
The clinical features, surgical procedures and outcome of two patients with mucinous appendiceal neoplasms were reviewed. The decision to move to total pelvic exenterative surgery after prior treatment failure was critically evaluated.
RESULTS
Patient 1 had three extensive surgical procedures prior to total pelvic exenteration and one surgical procedure after. Patient 2 had one 16-h surgical procedure prior to total pelvic exenteration. Patient 1 had 8 years and 1 month survival from onset of disease until death. Patient 2 is free of disease at 27 years from onset of pseudomyxoma peritonei. After recovery of the patients from the extensive surgery, their quality of life was acceptable.
CONCLUSION
Total pelvic exenteration surgery is seldom used in patients with peritoneal metastases from appendiceal neoplasms. These two patients were studied in an attempt to determine the indications for this procedure with this disease.
背景
包括腹膜切除术、脏器切除术和围手术期化疗在内的手术已被广泛用于治疗阑尾黏液腺癌的腹膜转移。治疗结果因肿瘤分级、腹部和盆腔疾病范围以及肿瘤切除的完整性而异。
方法
回顾了两名黏液性阑尾肿瘤患者的临床特征、手术过程和结果。对先前治疗失败后转而进行全盆腔脏器切除术的决定进行了严格评估。
结果
患者1在全盆腔脏器切除术之前进行了三次广泛的手术，之后进行了一次手术。患者2在全盆腔脏器切除术之前进行了一次长达16小时的手术。患者1从疾病发作到死亡存活了8年零1个月。患者2自腹膜假黏液瘤发作27年来无疾病。患者从广泛手术中恢复后，其生活质量尚可接受。
结论
全盆腔脏器切除术很少用于阑尾肿瘤腹膜转移患者。对这两名患者进行了研究，试图确定针对这种疾病进行该手术的适应症。
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