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恶性肿瘤腹腔镜和胸腔镜手术后的切口复发

Port site recurrences after laparoscopic and thoracoscopic procedures in malignancy.

作者信息

Johnstone P A, Rohde D C, Swartz S E, Fetter J E, Wexner S D

机构信息

Clinical Investigations Department, Naval Medical Center, San Diego, CA 92134-5000, USA.

出版信息

J Clin Oncol. 1996 Jun;14(6):1950-6. doi: 10.1200/JCO.1996.14.6.1950.

Abstract

PURPOSE AND METHODS

A review of the literature was performed to determine the number of cases of port site recurrences (PSR) after laparoscopy or thoracoscopy. CANCERLINE and MEDLINE were searched, as were citings from retrieved and related papers.

RESULTS

There have been 35 reported cases of PSR after laparoscopic colectomy for colorectal carcinoma, and 23 cases after thoracoscopic procedures for lung neoplasms. All of these have been reported since 1993. Since 1991, 12 cases have been described after laparoscopic cholecystectomy of unsuspected gallbladder carcinoma, and another case after biopsy of a known gallbladder carcinoma. Ten cases of PSR have been reported after laparoscopic procedures for ovarian lesions, often in the presence of peritoneal seeding at diagnosis. Other rare PSRs have been documented after several procedures in various malignancies.

CONCLUSION

Enrollment of patients onto the ongoing intergroup study evaluating open versus laparoscopic resection of colon cancer should be encouraged. Until valid prospective data on PSR frequency are available, laparoscopic or thoracoscopic resection of malignancy off-protocol should be undertaken with circumspection.

摘要

目的与方法

进行文献回顾以确定腹腔镜手术或胸腔镜手术后切口部位复发(PSR)的病例数。检索了CANCERLINE和MEDLINE以及从检索到的相关论文中引用的文献。

结果

已有35例关于腹腔镜结肠切除术治疗结直肠癌后发生PSR的报道,23例关于胸腔镜手术治疗肺部肿瘤后发生PSR的报道。所有这些报道均自1993年以来。自1991年以来,有12例在腹腔镜胆囊切除术中发现意外胆囊癌后发生PSR的报道,另有1例在已知胆囊癌活检后发生PSR的报道。有10例关于腹腔镜手术治疗卵巢病变后发生PSR的报道,这些病例在诊断时通常伴有腹膜种植转移。在各种恶性肿瘤的其他几种手术之后也记录到了其他罕见的PSR病例。

结论

应鼓励患者参加正在进行的比较结肠癌开放手术与腹腔镜手术切除的多组间研究。在获得关于PSR发生率的有效前瞻性数据之前,非规范的腹腔镜或胸腔镜恶性肿瘤切除术应谨慎进行。

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