右上象限腹膜切除术治疗卵巢恶性肿瘤腹膜转移的腹膜外入路。
Extraperitoneal Approach During Peritonectomy in the Right Upper Quadrant for Peritoneal Metastases from Ovarian Malignancies.
机构信息
Department of General and Visceral Surgery, Hospital Barmherzige Brüder, Regensburg, Germany;
Department of General and Visceral Surgery, Hospital Barmherzige Brüder, Regensburg, Germany.
出版信息
In Vivo. 2022 Jan-Feb;36(1):341-349. doi: 10.21873/invivo.12708.
AIM
To present the extraperitoneal approach for the removal of peritoneal metastases in the right upper abdomen in patients with ovarian cancer and to evaluate safety and potential advantages with comparison with the traditional approach.
PATIENTS AND METHODS
Detailed description of the right upper quadrant peritonectomy as extraperitoneal approach. Procedure-specific short-term complications were retrospectively analyzed in a cohort of patients.
RESULTS
Sixty-four patients were included. Full-thickness diaphragmatic resection was performed in 17% of primary cases, and in 44% of the patients with recurrent ovarian carcinoma. The rate of complete cytoreduction (CC-0) was 70%. The most common postoperative complication was pleural effusion (32%).
CONCLUSION
The extraperitoneal approach for peritonectomy of the right upper quadrant in patients with ovarian cancer is feasible, with improved access to the right subdiaphragmatic area. This enables a high rate of complete cytoreduction, and simplified and safe surgical dissection in an uncontaminated area under secured vascular structures. The early postoperative outcomes are comparable to those of the traditional transperitoneal approach.
目的
介绍一种经腹膜外途径行右上腹部腹膜转移瘤切除术的方法，评估其与传统经腹腔途径相比的安全性和潜在优势。
患者与方法
详细描述右上象限腹膜切除术的腹膜外途径。对一组患者的特定手术短期并发症进行回顾性分析。
结果
共纳入 64 例患者。17%的原发性病例和 44%的复发性卵巢癌患者行全层膈肌切除术。完全肿瘤减灭术（CC-0）率为 70%。最常见的术后并发症是胸腔积液（32%）。
结论
对于卵巢癌患者，经腹膜外途径行右上象限腹膜切除术是可行的，可改善对右膈下区域的显露。该途径可实现较高的完全肿瘤减灭术率，在受血管结构保护的无污染区域进行简化和安全的手术解剖。术后早期结果与传统经腹腔途径相当。
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