卵巢癌的腹膜后淋巴结清除术(附48例报告)  

Retroperitoneal Lymphadenectomy in Patients with Epithelial Overian Cancer(A Report of 48 Cases)

作　　者：王金华[1] 彭素蓉[1] 

机构地区：[1]江苏省肿瘤医院妇瘤外科,南京210009

出　　处：《肿瘤防治研究》2004年第9期569-570,共2页Cancer Research on Prevention and Treatment

基　　金：江苏省科委社会发展基金项目 (BS2 0 0 0 0 6 9)

摘　　要：目的　探讨卵巢上皮性癌分期探查术中腹膜后淋巴结清除术的方法和意义。方法　回顾分析4 8例分期探查卵巢癌病人中行腹膜后淋巴结清除术的临床资料。结果　腹膜后淋巴结转移率为39 .6 % (19/ 4 8) ,其中Ⅰ、Ⅱ、Ⅲ期分别为 15 .4 % (2 / 13)、2 2 .2 % (2 / 9)、5 7.6 % (15 / 2 6 ) ,4例Ⅰ、Ⅱ期病人发生淋巴转移 ,升级至Ⅲc期 ;术中髂外静脉损伤 2例 ,髂总静脉损伤 1例 ,下腔静脉损伤 5例 ,输尿管损伤 1例 ,肾静脉下淋巴结清除较肠系膜下动脉淋巴结清除手术难度明显加大 ,手术时间明显延长 ,出血量增多 ,术后肠功能恢复延长。结论　腹膜后淋巴结清除术不仅是卵巢癌准确分期的前提和必要条件 ,同时也是一种治疗手段 ,肠系膜下动脉起点的腹膜后淋巴结清除应视为卵巢癌分期探查和治疗的一部分 ,除有腹主动脉旁淋巴结肿大 ,否则 。Objective To investigate the way and role of retroperitoneal lymphadenectomy in patients with overian cancer.Methods From Jan. 2000 to Dec. 2002, 48 patients with ovarian cancer, treated by retroperitoneal lymphadenectomy, were studied.Results The rate of positive lymph nodes metastases was 39.6%(19/48), In stage Ⅰ,Ⅱ,Ⅲovarian cancer, the rate was respectively (15.4%)(2/13), (22.2%)(2/9), (57.6%)(15/26). During the operation, 8 cases' vein and 1 case's ureter were hurt. The operation of retroperitoneal lynphadenectomy from the renal vein was more difficult than from the inferior mesenteric artery. Amount of blood loss was more than the later. Time of operation was longer than the later. The function of intestine restoration was longer than the later.Conclusion Retroperitoneal lymphadendctomy from inferior mesenteric artery is a part of comprehensive staging laparotomy as well as a treatment in patients with ovarian cancer. We would rather not resect lymph nodes from renal vein unless the lymph nodes are suspicious metastases.

关 键 词：卵巢肿瘤 癌 淋巴结清除术 

分 类 号：R737.31[医药卫生—肿瘤]