经脐单孔腹腔镜联合上腹部开腹行晚期卵巢癌肿瘤细胞减灭术

Surgery for advanced epithelial ovarian cancer by transumbilical laparoendoscopic single-site surgery combined with upper abdominal laparotomy

目的探讨经脐单孔腹腔镜联合上腹部开腹行晚期卵巢癌肿瘤细胞减灭术的可行性、减瘤效果及手术安全性。方法回顾性分析2022年3月至2023年8月6例行经脐单孔腹腔镜联合上腹部开腹的晚期卵巢癌患者的手术方式和短期结局。结果6例患者手术均成功完成,且均达满意缩瘤(即达R0)。平均手术时间为417.50±103.09 min,平均手术出血量为566.67±273.25 ml,术后平均住院天数6.5±0.837 d,仅1例患者发生术后淋巴囊肿。6例患者术后均如期进行后续化疗。结论经脐单孔腹腔镜联合上腹部开腹手术方式保证晚期卵巢癌肿瘤细胞减灭术达R0的前提下,具有创伤最小化的优势,降低围手术期并发症,对患者快速康复和及时后续治疗有积极作用。这种联合手术方式是安全可行的。

Objective This study aims to investigate the feasibility and safety of debulking surgery(DS)via transumbilical laparoendoscopic single-site(TU-LESS)approach combined with upper abdominal laparotomy in advanced ovarian cancer.Methods Retrospective analysis of the perioperative outcomes of patients with advanced ovarian cancer who underwent TU-LESS combined with upper abdominal laparotomy from Mar.2022 to Aug.2023 in a single institution.Results Six patients underwent TU-LESS combined with upper abdominal laparotomy for DS successfully,and all of them achieved complete cytoreduction(R0).The average operative time was 417.50±103.09 mins,and the intraoperative bleeding was 566.67±273.25 ml,and the average postoperative hospital stay was 6.5±0.837 days.Only one patient developed postoperative lymphocyst.Six patients underwent follow-up chemotherapy as scheduled after DS.Conclusion TU-LESS approach combined with upper abdominal open surgery ensures tumor cell reduction and exhibits the characteristics of minimally invasive procedures,as well as,which impacts patient prognosis positively.This combined surgical approach is safe and feasible.