van Dam P A, Tjalma W, Weyler J, van Oosterom A T, Buytaert P
Department of Obstetrics and Gynaecology,Antwerp University Hospital, Edegem, Belgium.
Am J Obstet Gynecol. 1996 Mar;174(3):943-50. doi: 10.1016/s0002-9378(96)70331-9.
Our purpose was to evaluate the effectiveness, benefits, and potential side effects of the use of the cavitational ultrasonic surgical aspirator for cytoreduction of advanced ovarian cancer.
Forty patients with stage IIC to IV ovarian carcinoma were randomized to undergo ultraradical cytoreductive surgery with (group 1, 20 patients) or without (group 2, 20 patients) the use of the CUSA 200 cavitational ultrasonic surgical aspirator (Valleylab, Boulder, Colo). Preoperative and postoperative information and follow-up data were collected prospectively and compared between both groups.
The amount of residual tumor after debulking surgery, the duration of the operation, and the rate of perioperative complications were comparable in both study groups. The amount of perioperative blood loss was significantly lower (1450 ml vs 1650 ml, p=0.02) in group 1. These patients had less morbidity (p<0.05), and could be discharged from the hospital significantly sooner (14 days vs 16 days, p=0.031). CA 125 levels 1 and 2 months after surgery were significantly lower in the group with cavitational ultrasonic surgical aspirator (p<0.01 and p<0.01, respectively), suggesting more successful cytoreduction. However, this is not reflected in a better disease-free or overall survival.
Cavitational ultrasonic surgical aspirator-assisted cytoreductive surgery of advanced ovarian carcinoma is more effective in eradicating disease, reduces morbidity, and is cost beneficial.
我们的目的是评估使用超声空化手术吸引器对晚期卵巢癌进行肿瘤细胞减灭术的有效性、益处及潜在副作用。
40例IIc期至IV期卵巢癌患者被随机分为两组，一组（第1组，20例患者）使用CUSA 200超声空化手术吸引器（Valleylab公司，科罗拉多州博尔德市）进行超根治性肿瘤细胞减灭术，另一组（第2组，20例患者）不使用该吸引器进行手术。前瞻性收集两组患者术前、术后信息及随访数据并进行比较。
两组患者肿瘤减灭术后残留肿瘤量、手术时间及围手术期并发症发生率相当。第1组围手术期失血量显著较低（1450毫升对1650毫升，p = 0.02）。这些患者发病率较低（p < 0.05），出院时间显著更早（14天对16天，p = 0.031）。使用超声空化手术吸引器组术后1个月和2个月时CA 125水平显著较低（分别为p < 0.01和p < 0.01），提示肿瘤细胞减灭更成功。然而，这并未体现在无病生存期或总生存期的改善上。
超声空化手术吸引器辅助的晚期卵巢癌肿瘤细胞减灭术在根除疾病方面更有效，可降低发病率且具有成本效益。
