卵巢癌腹腔镜下大网膜切除术的改良

On the Modified Laparoscopic Omentum Resection in Patients With Ovarian Cancer

目的探讨卵巢癌改良腹腔镜下大网膜切除术的可行性和安全性。方法回顾性分析2017年1月~2018年12月58例腹腔镜手术治疗Ⅰa~Ⅲc期卵巢癌的临床资料,其中行腹腔镜下改良大网膜切除32例(研究组),腹腔镜下常规大网膜切除26例(对照组),比较2组手术时间、术中出血量、并发症发生情况。结果2组手术均顺利完成,研究组手术时间(31.3±4.7)min,明显短于对照组(51.9±3.9)min(t=-17.826,P=0.000);2组术中出血量差异无统计学意义[(6.1±2.5)ml vs.(6.7±4.2)ml,t=-0.712,P=0.480]。研究组1例脾门血管分支出血,对照组1例术中横结肠浆膜损伤,2组并发症发生率差异无显著性(Fisher精确检验,P=1.000)。结论卵巢癌腹腔镜手术中改良大网膜切除简单、安全,对设备要求不高,是可选择的一种手术方式。

Objective To investigate the feasibility and safety of modified laparoscopic resection of the omentum in ovarian cancer patients.Methods From January 2017 to December 2018,58 cases ofⅠa-Ⅲc ovarian cancer underwent laparoscopic resection of the omentum,including 32 cases of modified laparoscopic omentum resection(study group)and 26 cases of conventional laparoscopic omentum resection(control group).The clinical data such as operative time,blood loss,and complications were compared.Results The operations were carried out smoothly in both groups.The operation time of the study group and the control group were(31.3±4.7)min and(51.9±3.9)min,which was statistically significant(t=-17.826,P=0.000).The intraoperative blood loss had no significant difference between the two groups[(6.1±2.5)ml vs.(6.7±4.2)ml,t=-0.712,P=0.480].In the study group,there was 1 case of bleeding from the branches of splenic portal vessels,and in the control group there was 1 case of intraoperative serosal injury of transverse colon.There was no significant difference in the complication rate between the two groups(Fisher’s exact test,P=1.000).Conclusion Modified omentum resection under laparoscopy is simple,safe and feasible,with no special equipment required.