卵巢癌肿瘤细胞减灭术中整块切除盆腔肿瘤与受累之直、乙状结肠的研究

Study on low anterior en bloc resection as part of cytoreduction for advanced primary ovarian cancer patients

目的:探讨在卵巢癌肿瘤细胞减灭术中,整块切除盆腔肿瘤与受累之直肠、乙状结肠的可行性、有效性和安全性。方法:对35例原发性卵巢癌患者施行肿瘤细胞减灭术,根据术中发现卵巢肿瘤与直肠、乙状结肠粘连固定,进行整块切除盆腔肿瘤与受累之直肠、乙状结肠。观察手术病灶残留情况,手术时间,术中出血量和术中术后并发症。结果:29例(82.8%)达到满意肿瘤细胞减灭术(残留病灶<1 cm,平均手术时间375 min(185～510 min),估计手术平均出血量650 mL(200～2 100 mL)。1例术中损伤右侧输尿管。术后并发症包括切口感染7例(20%),术后病率5例(14.3%),肠梗阻2例(5.7%)和吻合口瘘1例(2.9%)。结论:作为晚期卵巢癌肿瘤细胞减灭术的一部分,整块切除盆腔肿瘤与受累之直肠、乙状结肠的手术方法是有效、安全、可行的。

Objective To study the efficacy and safety of low anterior en bloc resection of the rectosigmoid plus adjacent pelvic turnout as part of cytoreduction for primary ovarian cancer. Methods Thirty-five patients with primary ovarian cancer received an en bloc resection of ovarian turnout and a rectosigmoid resection in cytoreduetive surgery depending on the findings during operation. Parameters for safety and efficacy were analyzed as primary statistical endpoints. Results Optimal cytoreduction（residual turnout less than 1 cm） was achieved in 29 patients（82.8%）. An injury to the right urete took place during operation. Postoperative complications included 7 case of （20%） of wound complications, 5 （14.3%） of septicemia, 2 of （5.7%） ileus and 1 of （2. 9%） anastomotic leak. Conclusion An bloc resection of pelvic tumour and adjacent involved rectosigmoid as part of eytoreduction for ovarian cancer is effective and safe.