腹腔镜手术治疗卵巢癌18例临床分析

Clinical analysis of laparoscopy in treatment of ovarian cancer in 18 cases

目的探讨腹腔镜手术治疗卵巢癌的临床应用价值。方法回顾性分析18例(浆液性囊腺癌7例,卵巢子宫内膜样癌3例,粘液性囊腺癌3例,透明细胞癌3例,无性细胞瘤1例,未成熟畸胎瘤1例)卵巢癌患者病例,均行腹腔镜下分期,16例行腹腔镜手术治疗,统计手术时间、失血量、淋巴结切除数目、大网膜切除程度、住院时间、并发症、病理分期情况。结果全部患者手术均在腹腔镜下完成,手术时间(260.5±50.2)min、失血量(240.4±115.3)mL、淋巴结切除数目(11.3±1.3)个、住院时间(6.5±1.5)d,有1例皮下气肿的并发症。随访18例,5年存活率为:Ⅰ期90.1%,Ⅱ期33.3%。结论腹腔镜手术对卵巢癌分期准确,安全性高,住院时间短、创伤小。应用于卵巢癌再分期手术有实际的临床意义,可为早期卵巢癌手术治疗的新选择,但确切的临床意义有待大规模前瞻性随机对照研究证实。

Objective To evaluate the clinical value of laparoscopy in the treatment of ovarian cancer.Methods The clinical data of 18 patients with ovarian cancer who underwent laparoscopy（7 cases of mixing cystadenocarcinoma,3 cases of endometrium,3 cases of cystadenocarcinoma,3 cases of clear cell carcinoma,1 case of dysgerminoma and 1 case of immature teratoma） were retrospectively reviewed.The operation time,volume of blood loss,number of lymph node excision,extent of omentum majus excision,hospitalization duration,complication and pathological staging were analyzed.Results All patients were underwent laparoscopy,the operation time was（260.5±50.2） min,volume of blood loss was（240.4±115.3） mL,number of lymph node excision was（11.3±1.3）,hospitalization duration was（6.5±1.5） days.Complication of subcutaneous emphysema was occurred to one patient.All patients were followed up,the five-year survival rates was 90.1% in stage I and 33.3% in stage II.Conclusion With the advantages of accurate staging,high safety,short hospitalization time and invasiveness,laparoscopy is clinically significant for stage II ovarian cancer.But the exact clinical significance of laparoscopy needs to be confirmed by prospective randomized control trial in large scale.