重视FIGO Ⅰ期卵巢恶性肿瘤术中肿瘤破裂对预后的不利影响

Attention to the Adverse Effect of Intraoperative Capsule Rupture on Prognosis for Women with FIGO Stage Ⅰ Ovarian Malignancy

卵巢恶性肿瘤是复发率和病死率最高的妇科常见恶性肿瘤。手术是早期患者的首选治疗手段,预后较好。但随着腹腔镜手术越来越普及,术中肿瘤破裂的发生率逐渐升高。虽然开腹手术和腹腔镜手术中的肿瘤破裂都会对患者预后产生不良影响,但腹腔镜手术的肿瘤破裂风险更高,而术后辅助化疗不一定能起到补救性作用。对于预后较好的FIGO Ⅰ期卵巢恶性肿瘤,我们更应该重视这一问题,通过充分的术前评估、严格掌握腹腔镜适应证、规范的无瘤操作,避免术中肿瘤破裂导致的医源性分期上升及其给患者带来的不可逆影响。

Ovarian malignancy is a common gynecological malignant tumor with the highest recurrence rate and mortality.Surgery is the preferred treatment for early stage patients,leading to a good prognosis.However,with the increasing popularity of laparoscopic surgery,the incidence of intraoperative capsule rupture is gradually increasing.Although intraoperative capsule rupture in either laparotomy or laparoscopic surgery may have adverse effect on the prognosis,there is a higher risk of intraoperative capsule rupture in laparoscopic surgery,and postoperative adjuvant chemotherapy may not play a remedial role.For FIGO stage Ⅰ ovarian malignancy patients with a good prognosis,we should pay more attention to this issue,and avoid rise in iatrogenic stage caused by intraoperative capsule rupture and its irreversible impact on patients through adequate preoperative evaluation,strict mastery of laparoscopic indications,and standardized tumor-free surgery.