Blanc B, Nicoloso E, d'Ercole C, Cazenave J C, Boubli L
Service de Gynécologie-Obstétrique, Hôpital de La Conception, Marseille.
Presse Med. 1993 Nov 6;22(34):1732-4.
We report 2 cases of malignant ovarian tumours. These tumours had been missed at a first laparoscopic examination, and a second examination detected the presence of cancer cells disseminated in the peritoneum and the abdominal wall. The risk of propagation of an overlooked cancer makes it necessary to carry out a preoperative thorough evaluation based on clinical and ultrasonographic data before any attempt at laparoscopic surgery. If a laparoscopic treatment is decided, it must be performed under strict conditions and include meticulous exploration of the abdominal cavity, systematic peritoneal cytology, needle cytology of the cyst, emptying of the cyst in a water-tight manner, extemporaneous biopsy in case of doubt, peritoneal cleansing, and extraction of the cyst or the ovary in a bag. If malignancy is suspected, laparotomy must be performed immediately.
我们报告2例恶性卵巢肿瘤。这些肿瘤在首次腹腔镜检查时被漏诊,第二次检查发现癌细胞已扩散至腹膜和腹壁。由于被忽视的癌症存在扩散风险,因此在进行任何腹腔镜手术尝试之前,必须根据临床和超声数据进行术前全面评估。如果决定进行腹腔镜治疗,必须在严格条件下进行,包括对腹腔进行细致探查、系统的腹膜细胞学检查、囊肿穿刺细胞学检查、以防水方式排空囊肿、如有疑问进行术中活检、腹膜清洗以及将囊肿或卵巢装入袋中取出。如果怀疑为恶性,必须立即进行剖腹手术。