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[结直肠癌患者预防性卵巢切除术的适应证]

[Indications for prophylactic ovariectomy in patients with colorectal carcinoma].

作者信息

Gemos K, Rizzotti L, Tsardis P, Laopodis V, Gemos I, Scouras K, Patsalos C, Tierris E

机构信息

I Reparto Chirurgico, Ospedale Civile Croce Rossa Ellenica, Atene, Grecia.

出版信息

Minerva Chir. 1995 Jan-Feb;50(1-2):89-92.

PMID:7617268
Abstract

Metastasis of colorectal cancer to the ovaries presents in 2-8% of patients. Prevention of these metastasis with bilateral oophorectomy at the initial operation is quite simple, but nevertheless it produces an early menopause in premenopausal women and may add the morbility of the operation. Prophylactic oophorectomy is evaluated in a prospective study of 130 women that underwent surgery for adenocarcinoma of the large bowel. Forty-four of these patients underwent unilateral (10 patients) or bilateral (34 patients) oophorectomy along with the large bowel resection. Fifty-five women were submitted to colectomy alone, while 31 with or without oophorectomy were lost to the follow-up. Of the 44 women that underwent oophorectomy, 8 were premenopausal, while 36 were postmenopausal. The tumor was situated at the right colon in 5 out of the 44 patients that underwent oophorectomy and at the left colon in the remaining 39. According to Dukes classification, 5 tumors were Dukes A, 22 Dukes B and 17 Dukes C. Two of the 44 patients were found to harbour metastasis to the ovaries (4.5%). One of these patients was premenopausal (12.5%) and 1 was postmenopausal (2.7%). Of the 55 women that underwent colectomy, only one developed metastasis to the ovaries during the follow-up period (1.8%). No metastasis was detected at the resected ovary or at the remaining ovary during the follow-up period, among the patients that underwent unilateral oophorectomy. No complication directly related to the oophorectomy was noted.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

结直肠癌转移至卵巢的情况在2%至8%的患者中出现。在初次手术时通过双侧卵巢切除术预防这些转移相当简单,但这会使绝经前女性过早绝经,且可能增加手术的发病率。在一项对130例接受大肠腺癌手术的女性进行的前瞻性研究中,对预防性卵巢切除术进行了评估。这些患者中有44例在进行大肠切除术的同时接受了单侧(10例患者)或双侧(34例患者)卵巢切除术。55名女性仅接受了结肠切除术,而31名接受或未接受卵巢切除术的女性失访。在接受卵巢切除术的44名女性中,8名是绝经前女性,36名是绝经后女性。在接受卵巢切除术的44例患者中,5例肿瘤位于右半结肠,其余39例位于左半结肠。根据Dukes分期,5例肿瘤为Dukes A期,22例为Dukes B期,17例为Dukes C期。44例患者中有2例被发现有卵巢转移(4.5%)。其中1例患者为绝经前女性(12.5%),1例为绝经后女性(2.7%)。在接受结肠切除术的55名女性中,只有1例在随访期间发生了卵巢转移(1.8%)。在接受单侧卵巢切除术的患者中,随访期间在切除的卵巢或剩余的卵巢中未检测到转移。未观察到与卵巢切除术直接相关的并发症。(摘要截选至250字)

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