腹腔镜在早期卵巢恶性肿瘤再分期手术中的应用  

The application of laparoscopy in the restaging surgery of early ovarian malignant tumor

作　　者：成九梅[1] 段华[1] 刘芸[1] 张颖[1] 王金娟[1] 

机构地区：[1]首都医科大学附属北京妇产医院妇科微创诊治中心,100006

出　　处：《北京医学》2015年第11期1072-1074,共3页Beijing Medical Journal

基　　金：北京市医管局重点医学发展计划项目杨帆计划(zylx201406)

摘　　要：目的探讨腹腔镜在早期卵巢恶性肿瘤再分期手术中的临床应用价值。方法回顾性分析16例腹腔镜下早期卵巢恶性肿瘤再分期手术患者的临床资料,初次手术后诊断Ia期13例,Ic期3例,手术包括腹腔镜下全子宫切除术、保留附件切除术、骨盆漏斗韧带高位结扎术、大网膜切除术、盆腔及腹主动脉旁淋巴结清扫术和（或）阑尾切除术。结果 16例患者均在腹腔镜下顺利完成再分期手术,无术中及术后并发症发生,术中出血量（86.5±30.6）ml,手术时间（160.6±36.9）min,盆腔淋巴结切除数量（19.5±4.6）个、腹主动脉旁淋巴结切除数量（6.5±2.6）个,术后分期1例由Ia期上升至Ib期,2例由Ia期上升至Ic期,1例由Ic期上升至IIIc期,对分期为Ib期以上的或有高危因素的常规PT方案化疗3-6个疗程,随访过程无复发及穿刺孔转移。结论腹腔镜下早期卵巢恶性肿瘤再分期手术是安全可行的,有利于准确确定分期、指导术后辅助化疗,符合目前肿瘤治疗兼顾微创和根治性的趋势。Objective To evaluate the clinical value of laparoscopic restaging surgery for women with early ovarian malignant tumor. Methods The clinical data of 16 patients with early ovarian malignant tumor undergoing laparoscopic restaging surgery were collected and analysed retrospectively. Thirteen patients with stage Ia and 3 cases with stage Ic were diagnosed after the first surgery. The surgery included laparoscopic hysterectomy, total hysterectomy for retention of attachment, high ligation of pelvic funnel ligament, omentectom, pelvic and paraaortic lymphadenectomy and/or appendectomy. Results All 16 restaging operations were performed via the laparoscopic approach. There were no intraoperative and postoperative complications. The intraoperative blood loss was（86.5 ± 30.6）ml. The mean operation time was（160.6±36.9）min. The number of pelvic lymph nodes resected was 19.5±4.6. The number of paraaortic lymph nodes resected was 6.5±2.6. The staging of one patient was upstaged from Ia to Ib, two patients were upstaged from Ia to Ic, and one patient was upstaged from Ic to IIIc. For patients with stage Ib or over Ib and patients with high risk factors, routine PT chemotherapy was given for 3-6 cycles. There was no recurrence and metastasis in the following-up periods. Conclusion The results confirm the feasibility and safety of laparoscopic restaging operations for women with early ovarian malignant tumor. It is helpful for the accurate staging and the guidence of adjuvant chemotherapy, which is in accordence with the trend of minimally invasive and radical treatment for early ovarian malignant tumor.

关 键 词：早期卵巢恶性肿瘤 腹腔镜 再分期手术 

分 类 号：R737.31[医药卫生—肿瘤]