阴式辅助技术在盆腔高负荷卵巢癌肿瘤细胞减灭术中的应用

发布时间：2018-10-24 18:48

【摘要】：目的:探讨经阴道、直肠指示的辅助技术(简称阴式辅助技术)在盆腔高负荷卵巢癌肿瘤细胞减灭术中的应用价值。方法:对38例盆腔高负荷卵巢癌患者在行肿瘤细胞减灭术时采用阴式辅助技术。观察盆腔减瘤结局、脏器保留情况、相关并发症及远期复发情况。结果:全腹盆腔理想减瘤31例(81.6%);盆腔理想减瘤36例(94.7%),其中肉眼无瘤14例(36.8%);直肠、乙状结肠切除18例(47.4%),均达到理想减瘤;直肠、乙状结肠保留20例(52.6%),理想减瘤18例(90.0%)。术中盆腔副损伤5例(13.2%),术后直肠、乙状结肠吻合口瘘并盆腔感染1例,下肢静脉血栓2例;无围手术期死亡病例。34例随访患者中复发11例,分别为单纯盆腔复发2例、盆腔合并其他部位复发4例及盆腔外其他部位单发或多发转移5例,远期局部复发率为17.6%(6/34),复发病例中2例死亡。结论:阴式辅助技术用于盆腔高负荷卵巢癌肿瘤细胞减灭术,盆腔减瘤效果理想,最大限度保留了直肠、乙状结肠,安全可行,远期局部复发率低。
[Abstract]:Objective: to evaluate the value of transvaginal and rectal indication in the reduction of tumor cells in pelvic high-load ovarian cancer. Methods: 38 patients with pelvic high-load ovarian cancer were treated with negative assisted technique. The outcome of pelvic tumor reduction, organ retention, related complications and long-term recurrence were observed. Results: there were 31 cases (81.6%) of total abdominal and pelvic ideal tumor reduction, 36 cases (94.7%) of pelvic ideal tumor reduction, 14 cases (36.8%) of naked eye without tumor, 18 cases (47.4%) of rectum and sigmoid colon resection, 20 cases (52.6%) of sigmoid colon preservation and 18 cases (90.0%) of ideal reduction of tumor. Pelvic accessory injury was found in 5 cases (13.2%), postoperative rectal and sigmoid anastomotic fistula with pelvic infection in 1 case, venous thrombosis in lower extremity in 2 cases, and no perioperative death. There were 4 cases of pelvic recurrence with other sites and 5 cases of single or multiple metastases outside the pelvic cavity. The long-term local recurrence rate was 17.6% (6 / 34). 2 cases died of recurrence. Conclusion: the negative assisted technique is effective in the reduction of tumor cells of ovarian cancer with high load in pelvic cavity. It preserves rectum and sigmoid colon to the maximum extent and is safe and feasible. The long-term local recurrence rate is low.
【作者单位】：郑州大学附属肿瘤医院;
【分类号】：R737.31

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