Odajima Suguru, Tanabe Hiroshi, Koike Yuki, Yokosu Kota
Department of Gynecology, National Cancer Center Hospital East, Chiba, Japan.
Cancer Diagn Progn. 2022 Jul 3;2(4):482-488. doi: 10.21873/cdp.10131. eCollection 2022 Jul-Aug.
BACKGROUND/AIM: Total parietal peritonectomy (TPP) is a surgical procedure used for complete resection of microscopic peritoneal dissemination. This study analyzed the perioperative complications that developed when omitting systematic lymphadenectomy from TPP.
We retrospectively analyzed perioperative complications in epithelial ovarian cancer patients with stage IIIB-IVB who underwent TPP during primary and interval cytoreductive surgeries between April 2018 and October 2021.
Thirty-three patients were enrolled in the study. The median patient age was 62 years. Of 31 patients (94%) with stage IIIC/IV disease, 24 (73%) had high-grade serous carcinoma. The median operative time and blood loss were 447 min and 2,831 ml, respectively. Complete tumor resection was performed in 30 patients (91%). Only five patients underwent partial lymphadenectomy for clinical metastatic lymph nodes. Further, grade 3 complications were observed in seven (21%) patients, and there were no fatal events in this study. Three patients (9%) had ureteric injuries, which was the most frequent complication in this study. Only one patient developed an intra-abdominal infection due to ascites. In this case, partial para-aortic and pelvic lymphadenectomies were performed.
TPP without systematic lymphadenectomy reduces the frequency of perioperative complications associated with ascites.
背景/目的:全腹膜切除术(TPP)是一种用于彻底切除微小腹膜播散灶的外科手术。本研究分析了在TPP中省略系统性淋巴结清扫术时发生的围手术期并发症。
我们回顾性分析了2018年4月至2021年10月期间在初次和间隔减瘤手术中接受TPP的IIIB-IVB期上皮性卵巢癌患者的围手术期并发症。
33例患者纳入本研究。患者中位年龄为62岁。在31例(94%)IIIC/IV期疾病患者中,24例(73%)为高级别浆液性癌。中位手术时间和失血量分别为447分钟和2831毫升。30例患者(91%)实现了肿瘤完全切除。仅5例患者因临床转移淋巴结接受了部分淋巴结清扫术。此外,7例(21%)患者出现3级并发症,本研究中无致命事件。3例患者(9%)发生输尿管损伤,这是本研究中最常见的并发症。仅1例患者因腹水发生腹腔内感染。在此病例中,进行了部分腹主动脉旁和盆腔淋巴结清扫术。
不进行系统性淋巴结清扫的TPP可降低与腹水相关的围手术期并发症发生率。