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目的探讨复发性卵巢上皮癌二次肿瘤细胞减灭术中实施侵袭性术式的必要性及多学科手术团队参与的意义。方法收集郑州大学附属肿瘤医院妇瘤科接受二次肿瘤细胞减灭术复发性卵巢上皮癌患者的临床及手术资料,共62例,依据手术团队学科组成分为两组:妇瘤科手术组18例,妇瘤科与胃肠、肝胆外科医师多学科手术组44例。依据术中发现,评估清除所有病灶时所需侵袭性手术例次;比较2组实际侵袭性术式实施例数、减瘤结局及手术并发症。结果依术中发现评估,7例(11.3%)无需侵袭性手术、47例(75.8%)需要83例次侵袭性手术方式可达到肉眼无瘤。两组围手术期均无死亡病例。结论复发性卵巢癌二次肿瘤细胞减灭术以肉眼无瘤为减瘤目标,多需实施上腹部脏器及结直肠切除的侵袭性手术方式,多学科共同施术是获得理想手术结局的保证。
Objective To investigate the necessity of invasive procedure in secondary tumor cytoreductive surgery for recurrent epithelial ovarian cancer and the significance of multidisciplinary surgical teams. Methods The clinical and surgical data of 62 patients with recurrent epithelial ovarian cancer undergoing secondary cytoreductive surgery were collected from Department of Gynecology and Oncology, Affiliated Tumor Hospital, Zhengzhou University.A total of 62 cases were divided into two groups according to the disciplinary team: Cases, gynecologic and gastrointestinal, hepatobiliary surgeon multidisciplinary surgery group of 44 cases. According to the intraoperative findings, we evaluated the number of invasive surgical procedures required to clear all the lesions; and compared the number of actual invasive surgical procedures, tumor reduction outcomes and surgical complications in the two groups. Results According to the intraoperative findings, 7 patients (11.3%) did not require invasive surgery and 47 (75.8%) required 83 sub-invasive surgical procedures to achieve gross non-tumor appearance. There were no deaths in either group during perioperative period. Conclusions Secondary cytoreductive surgery for recurrent ovarian cancer is a non-naked tumor-reducing target. It requires more invasive surgical procedures for upper abdominal organs and colorectal resection. Multidisciplinary co-operation is the guarantee of the ideal surgical outcome .