Crawford R A, Gore M E, Shepherd J H
Gynaecology Unit, Royal Marsden Hospital, London, UK.
Br J Obstet Gynaecol. 1995 Sep;102(9):726-30. doi: 10.1111/j.1471-0528.1995.tb11431.x.
To review the clinical features of women with ovarian cancer on whom minimal access surgery has been performed and to determine guidelines for the safe use of minimal access surgery for adnexal masses.
Postal survey of members of the British Gynaecological Cancer Society (BGCS) and retrospective case review.
BGCS consultants used ultrasound scanning (70%) and serum CA-125 estimations (53%) prior to adnexal mass surgery. The membership felt that adnexal masses with solid elements, diameter greater than 8 cm, multi-ocular or bilateral cysts or increased blood flow on Doppler scanning should not be operated on by minimal access surgery. A positive family history was also considered to be a contraindication. A total of 29 cases of ovarian cancer were identified on whom MAS had been performed. The incidence of cases was 4.1% of referrals to a tertiary referral centre (the Royal Marsden Hospital). The median age of patients was 37 years (range 20 to 68 years) and 13 had State I cancers. The mean delay between diagnosis and staging was 6.5 weeks.
Guidelines on the use of minimal access surgery in the management of adnexal masses need to be agreed. Women who have an ovarian cancer diagnosed whilst having minimal access surgery should have an accepted staging procedure. We do not recommend the routine use of minimal access surgery for the treatment of ovarian cancer outside a trial.
回顾接受微创手术的卵巢癌女性患者的临床特征，并确定附件肿块微创手术安全使用的指南。
对英国妇科癌症协会（BGCS）成员进行邮政调查及回顾性病例分析。
BGCS顾问在附件肿块手术前使用超声扫描（70%）和血清CA-125检测（53%）。成员们认为，具有实性成分、直径大于8cm、多房或双侧囊肿或多普勒扫描显示血流增加的附件肿块不应进行微创手术。阳性家族史也被视为禁忌证。共确定29例接受过微创手术的卵巢癌病例。病例发生率占三级转诊中心（皇家马斯登医院）转诊患者的4.1%。患者中位年龄为37岁（范围20至68岁），13例为I期癌症。诊断与分期之间的平均延迟为6.5周。
需要就附件肿块管理中微创手术的使用指南达成共识。在接受微创手术时被诊断为卵巢癌的女性应接受公认的分期程序。我们不建议在试验之外常规使用微创手术治疗卵巢癌。
