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[卵巢癌的肠切除术]

[Bowel resections in cancers of the ovary ].

作者信息

Kauffmann P, Le Bouëdec G, Dauplat J

机构信息

Centre Jean-Perrin, Clermont-Ferrand.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 1993;22(5):501-8.

PMID:7693794
Abstract

The authors report a retrospective series of 32 patients who were operated on by resection of bowel at various stages during the progress of epithelial pathology of malignant ovaries. These operations were carried out in one group during the initial operation, in a second group during a "second-look" operation and in a third group when late recurrences had occurred. Removal of bowel was possible to remove completely or to optimum effect malignant cell bearing areas in 22 cases (59%) and less than optimal reductions in 15 cases (41%). Forty-five different segments of bowel were resected consisting of 18 of the rectum and sigmoid, 11 of the right side of the colon, 9 transverse or left colon, and 5 of the small intestine and 2 of the stomach. One patient died from cardio-respiratory failure immediately after the operation. Seven cases had septic abdominal complications but they settled quickly without further surgery. It was not possible on studying the follow-up of these patients to find any statistically significant improvement in those who had complete or optimum resection as compared with those who were less completely operated on, and those who were operated on in a late stage of the illness. All the same even if it is not possible to show that there is a significant improvement in survival in the populations that have been compared in this study, it does seem advisable to practice bowel resection in order to reduce as much as possible cancer bearing cells so that chemotherapy can be applied more effectively and thus improve the prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

作者报告了一组32例回顾性病例,这些患者在恶性卵巢上皮病变进展的不同阶段接受了肠切除术。这些手术中,一组在初次手术时进行,二组在“二次探查”手术时进行,三组在出现晚期复发时进行。在22例(59%)患者中,肠切除能够完全切除或达到最佳效果,即切除含恶性细胞区域;15例(41%)患者的切除效果欠佳。共切除了45个不同节段的肠,其中直肠和乙状结肠18段,结肠右侧11段,横结肠或左结肠9段,小肠5段,胃2段。1例患者术后立即死于心肺衰竭。7例出现了腹部感染并发症,但未经进一步手术便迅速好转。在对这些患者进行随访研究时发现,与切除不彻底或在疾病晚期接受手术的患者相比,接受完全或最佳切除的患者并无统计学上的显著改善。即便如此,尽管在本研究比较的人群中无法证明生存有显著改善,但为了尽可能减少癌细胞数量以便更有效地进行化疗从而改善预后,进行肠切除似乎仍是可取的。(摘要截选至250词)

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