经单孔腹腔镜行细胞减灭术联合腹腔内热化疗治疗低级别腹膜恶性肿瘤。
Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy by laparoscopy via a single-port approach for low-grade peritoneal malignancy.
机构信息
Department of Digestive Oncological Surgery, West Cancer Institute, Boulevard Jacques Monod, 44800, Saint Herblain, France.
Department of Digestive Surgery, University Hospital, Nantes, France.
出版信息
Surg Endosc. 2020 Jun;34(6):2789-2795. doi: 10.1007/s00464-020-07492-w. Epub 2020 Mar 12.
BACKGROUND
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a long and complex procedure. A minimal invasive approach is rarely performed. The feasibility of laparoscopic CRS and HIPEC via a single port (SP) approach is unknown. The aim of this study was to assess the feasibility of CRS and HIPEC with a SP approach.
METHODS
This study is IDEAL stage I-IIa. Patients with low grade and limited peritoneal malignancy were included in a tertiary care cancer center. Intra- and post-operative adverse events were recorded and classified according to medical and surgical dedicated classifications. The main objective measurement to assess feasibility was the conversion to open or multiport surgery.
RESULTS
A total of 12 highly selected patients were assessed. The median operating time was 240 min (range, 180-360) and two near miss events were reported. Two conversions to open and multiport surgery occurred. The median comprehensive complication index was 0 (range, 0-42.6) with two severe adverse events (Clavien-Dindo or CTC-AE ≥ 3). The median length of stay was 8.5 days (range, 5-13).
CONCLUSION
CRS and HIPEC via a laparoscopic SP approach are feasible and safe in the short term. The next step should be a prospective development study.
背景
细胞减灭术（CRS）和腹腔热灌注化疗（HIPEC）是一个漫长而复杂的过程。很少采用微创方法。通过单端口（SP）途径进行腹腔镜 CRS 和 HIPEC 的可行性尚不清楚。本研究旨在评估通过 SP 途径进行 CRS 和 HIPEC 的可行性。
方法
这是一项 IDEAL 分期 I-IIa 的研究。低级别和局限性腹膜恶性肿瘤患者被纳入三级癌症中心。记录术中及术后不良事件，并根据医疗和外科专用分类进行分类。评估可行性的主要客观测量指标是转为开放或多孔手术。
结果
共评估了 12 名高度选择的患者。中位手术时间为 240 分钟（范围 180-360 分钟），报告了两起接近失败事件。有两例转为开放和多孔手术。中位综合并发症指数为 0（范围 0-42.6），有两例严重不良事件（Clavien-Dindo 或 CTC-AE≥3）。中位住院时间为 8.5 天（范围 5-13 天）。
结论
通过腹腔镜 SP 途径进行 CRS 和 HIPEC 在短期内是可行且安全的。下一步应该是前瞻性发展研究。
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