晚期卵巢癌腹腔镜肿瘤细胞减灭术的安全性和有效性分析

发布时间：2018-03-22 10:03

本文选题：腹腔镜手术　切入点：晚期卵巢癌　出处：《中国微创外科杂志》2017年12期 　论文类型：期刊论文

【摘要】：目的探讨腹腔镜下晚期卵巢癌肿瘤细胞减灭术的安全性和有效性。方法我院2013年1月~2016年12月手术治疗晚期卵巢癌50例,其中22例行腹腔镜肿瘤细胞减灭术(腹腔镜组),28例行开腹肿瘤细胞减灭术(开腹组),比较2组手术时间、术中出血量、淋巴结切除数目、切净率、术后排气时间、住院时间、并发症发生率和复发等情况。结果与开腹组比较,腹腔镜组术中出血量明显减少[(181.8±74.9)ml vs.(393.9±280.6)ml,t=-3.443,P=0.001],术后肛门排气时间[(1.6±0.7)d vs.(3.2±0.9)d,t=-6.861,P=0.000]和术后住院时间[(11.0±3.6)d vs.(16.1±5.9)d,t=-3.562,P=0.000]均明显缩短。2组手术时间、淋巴结切除数目、切净率、并发症发生率均无统计学意义(P0.05)。腹腔镜组1例术中髂外静脉损伤,1例乙状结肠损伤,均在镜下完成缝合。开腹组1例术中髂总静脉损伤,成功修补,1例术后下肢静脉血栓,抗凝治疗好转。50例随访4~52个月,中位随访时间23.5月,2组复发率差异无统计学意义(P0.05)。结论腹腔镜下晚期卵巢癌肿瘤细胞减灭术安全、可行,近期疗效满意,但要求病例选择得当,而且术者及团队需具备熟练的操作技术及处理手术并发症的经验。
[Abstract]:Objective to evaluate the safety and efficacy of laparoscopic surgery for the treatment of 50 patients with advanced ovarian cancer from January 2013 to December 2016. Among them, 22 cases underwent laparoscopic tumor cell reduction (laparoscopy group 28 cases open tumor cell reduction operation (laparotomy group, comparison of operative time, intraoperative bleeding volume, number of lymph node excision, removal rate, postoperative exhaust time, hospital stay). Results compared with the laparotomy group, the intraoperative bleeding volume in the laparoscopy group was significantly reduced [181.8 卤74.9)ml 卤280.6 vs.(393.9 卤280.6 vs.(393.9 卤3.443U P0. 001], the postoperative anus exhaust time [1.6 卤0.7d vs.(3.2 卤0.9dndtti-6.861P0.000] and the postoperative hospitalization time (11.0 卤3.6d vs.(16.1 卤5.562P0.000) were significantly shortened, the number of lymphadenectomies was reduced, the number of lymph nodes was removed, the number of lymph nodes was removed, the number of lymph nodes was removed, the number of lymph nodes was removed, the number of lymph nodes was removed, the number of lymph nodes was removed, the number of lymph nodes was removed, the number of lymph nodes was removed, the number of lymph nodes was removed, the number of lymph nodes was removed. The rate of resection and the incidence of complications were not statistically significant (P 0.05). In the laparoscopic group, 1 case of external iliac vein injury and 1 case of sigmoid colon injury were sutured under the microscope, and 1 case in the laparotomy group had common iliac vein injury during the operation, 1 case in the laparotomy group, and 1 case in the laparotomy group. One case of lower extremity venous thrombosis was repaired successfully and 50 cases were followed up for 4 ~ 52 months. The median follow-up time was 23.5 months. There was no significant difference in recurrence rate between the two groups (P 0.05). Conclusion Laparoscopic reduction of tumor cells in advanced ovarian cancer is safe and feasible. Short-term results are satisfactory, but case selection is required, and the operator and team must have skilled operation skills and experience in the management of surgical complications.
【作者单位】：北京市顺义区妇幼保健院妇科北京儿童医院顺义妇儿医院妇科;中国医科大学北京顺义医院普外科;中国医科大学北京顺义医院泌尿外科;
【分类号】：R737.31

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