Arts H J, Willemse P H, Tinga D J, de Vries E G, van der Zee A G
Department of Gynaecology, Groningen University Hospital, The Netherlands.
Gynecol Oncol. 1998 Apr;69(1):32-5. doi: 10.1006/gyno.1998.4968.
To our report our experience with the laparoscopic placement of peritoneal access ports and to compare it to our experience with placement at laparotomy.
Patients with advanced ovarian carcinoma were enrolled in a study to receive intraperitoneal paclitaxel in combination with intravenous cisplatin and cyclophosphamide as first- or second-line chemotherapy. Patients had a PAP catheter placed at primary laparotomy or by a separate laparoscopic procedure under general anesthesia.
In 13 patients a PAP catheter was placed during primary laparotomy, without complications. Thirteen patients had laparoscopic catheter placing, using routine Veress needle insufflation. After a bowel perforation at insertion of the umbilical trocar had occurred in one patient, due to extensive adhesions, we decided to use only an open laparoscopic procedure. No other procedure or catheter-related complications occurred.
Laparoscopic-assisted placement of PAP catheters is feasible, but should preferably be performed by an open laparoscopic procedure in this patient population at risk for intraabdominal adhesions.
报告我们腹腔镜放置腹膜置管端口的经验，并与剖腹手术放置的经验进行比较。
晚期卵巢癌患者参加一项研究，接受腹腔内紫杉醇联合静脉注射顺铂和环磷酰胺作为一线或二线化疗。患者在初次剖腹手术时或在全身麻醉下通过单独的腹腔镜手术放置腹膜置管（PAP）导管。
13例患者在初次剖腹手术期间放置了PAP导管，无并发症。13例患者接受腹腔镜导管放置，采用常规韦尔斯针充气法。1例患者因广泛粘连，在插入脐部套管针时发生肠穿孔，因此我们决定仅采用开放式腹腔镜手术。未发生其他手术或与导管相关的并发症。
腹腔镜辅助放置PAP导管是可行的，但在有腹腔粘连风险的患者群体中，最好采用开放式腹腔镜手术。
