摘要
目的探讨多学科协作诊疗模式指导初治晚期卵巢癌肿瘤减灭术的效果。方法回顾性分析2020年3月-2022年5月在南京医科大学附属常州第二人民医院妇科接受多学科协作诊疗模式指导卵巢癌肿瘤细胞减灭术的13例初治晚期卵巢癌的临床及随访资料并进行总结分析。结果13例晚期卵巢癌患者经多学科协作诊疗模式指导,3例多学科协作诊疗模式(multi-disciplinary treatment,MDT)评估及腹腔镜探查发现不能达到RO切除,组织活检后终止手术,行新辅助化疗(neoadjuvant chemotherapy,NACT)加中间性肿瘤细胞减灭术(interval debulking surgery,IDS)达到RO切除;3例MDT评估初始肿瘤细胞减灭术(primary debulking surgery,PDS)无法达到RO切除,直接腹水脱落细胞及转移病灶穿刺明确恶性肿瘤后行新辅助化疗,行IDS达到R 0切除;其余7例行PDS均达到RO切除,初始肿瘤细胞减灭术RO切除率达到53.85%,总R 0切除率100%。1例患者切口愈合不良,1例患者术后出现左心衰竭合并急性肺水肿,经治疗后均好转,所有患者均顺利出院。出院后随访至2022年7月,其中4例患者术后复发。结论多学科协作模式指导卵巢癌初次肿瘤细胞减灭术可有效提高晚期卵巢癌手术RO率,减少手术并发症,可能是一种治疗晚期卵巢癌更安全、有效的方法。
Objective To investigate the effect of multi-disciplinary treatment model in guiding cytoreductive surgery for advanced ovarian cancer.Methods The clinical and follow-up data of 13 cases of advanced ovarian cancer who received cytoreduction of ovarian cancer in the Department of Gynecology,Changzhou Second People's Hospital Affiliated to Nanjing Medical University from March 2020 to May 2022 were retrospectively analyzed.Results Among 13 patients with advanced ovarian cancer,3 patients were found to be unable to achieve R 0 resection by multi-disciplinary treatment(MDT)evaluation and laparoscopic exploration.Interval debulking surgery(IDS)was performed after neoadjuvant chemotherapy(NACT).After NACT,the patients underwent interval debulking surgery to achieve R0 resection.In 3 cases,R0 of primary debulking surgery(PDS)could not be achieved by MDT evaluation.NACT was performed after direct ascites shedding cells and biopsy of metastatic lesions,and R0 resection was achieved by IDS.The R0 resection rate of(PDS)was 53.85%and the total R0 resection rate was 100%.There was poor wound healing in 1 patient,and left heart failure complicated with acute pulmonary edema in 1 patient after operation,which were improved after treatment.All patients were discharged successfully.After discharge,the patients were followed up until July 2022.Four patients had postoperative recurrence.Conclusion The multidisciplinary treatment model guiding cytoreductive surgery can effectively improve the R0 rate and reduce surgical complications in advanced ovarian cancer surgery.It may be a safer and more effective method for the treatment of advanced ovarian cancer.
作者
魏炜炜
钱峻
胡玉霆
沈化及
肖惠超
陆佳
蒋云芬
郑亚峰
WEI Weiwei;Qian Jun;Hu Yuting;SHEN Huaji;XIAO Huichao;LU Jia;JIANG Yunfen;ZHENG Yafeng(Department of Gynecology,the Affiliated Changzhou Second People's Hospital of Nanjing Medical University,Changzhou,Jiangsu 213000,China;Department of Gastrointestinal Disease Center,the Changzhou Second Peoples’Hospital Affiliated to Nanjing Medical University,Changzhou,Jiangsu 213000,China;Department of Hepatobiliary and Pancreatic Surgery,the Changzhou Second Peoples’Hospital Affiliated to Nanjing Medical University,Changzhou,Jiangsu 213003,China)
出处
《手术电子杂志》
2022年第4期19-25,共7页
Electronic Journal of Medical Operations
关键词
多学科协作
卵巢癌
肿瘤细胞减灭术
multi-disciplinary treatment
ovarian cancer
cytoreductive surgery
