Park Soo Jin, Kim Hee Seung
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Gland Surg. 2021 Mar;10(3):1268-1270. doi: 10.21037/gs.2020.04.08.
The effect of debulking surgery is not vague in patients with refractory ovarian cancer because of drug-resistant tumor biology showing rapid growth. However, it can be considered to be beneficial for selected patients expected to show tumor response by postoperative treatment because the better perfused small tumors may favor the action of cytotoxic therapy. Among them, patients with enlarged lymph nodes and mutations can show a relatively high rate of response and improved survival by systematic lymphadenectomy followed by poly ADP ribose polymerase (PARP) inhibitors. However, the resection of enlarged lymph nodes above the renal vein may not be familiar to gynecologic oncologists, in particular, for patients who had undergone previous debulking surgery followed by repetitive chemotherapy. Thus, this video will show the step by step procedure of suprarenal lymphadenectomy and resection of kidney and suprahilar lymph nodes for complete resection of refractory ovarian cancer.
对于难治性卵巢癌患者，减瘤手术的效果并不模糊，因为耐药肿瘤生物学表现为快速生长。然而，对于预期术后治疗会显示肿瘤反应的特定患者，可认为减瘤手术有益，因为灌注较好的小肿瘤可能有利于细胞毒性疗法发挥作用。其中，有肿大淋巴结和基因突变的患者，通过系统性淋巴结清扫术，随后使用聚ADP核糖聚合酶（PARP）抑制剂，可显示出相对较高的反应率和生存率改善。然而，肾静脉上方肿大淋巴结的切除可能不为妇科肿瘤学家所熟悉，尤其是对于先前接受过减瘤手术并反复化疗的患者。因此，本视频将展示肾上腺淋巴结清扫术以及肾脏和肾门上方淋巴结切除术的逐步操作过程，以实现难治性卵巢癌的完全切除。
