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目的 探讨卵巢癌再分期手术的价值及其并发症的发生情况。方法 42例患者均为本院 1986年 1月至 1996年 1月收治的外院初次手术时未进行全面探查而诊断为Ⅰa～Ⅱa期的卵巢癌患者。其中 ,Ⅰa期 2 8例 ,Ⅰb期 1例 ,Ⅰc期 12例 ,Ⅱa期 1例 ;卵巢上皮性癌 2 6例 ,恶性生殖细胞肿瘤 9例 ,颗粒细胞肿瘤 7例。外院初次手术仅行患侧附件切除术 40例。结果 42例患者中 12例(2 8 6 % )患者经再分期手术证实期别提高 ,其中 8例 (19 0 % )实际应为Ⅲ期患者。 12例再分期手术阳性患者 (指再分期手术时发现有残存肿瘤者 )中 ,腹水或腹腔冲洗液细胞学检查有癌细胞者 3例 ,结肠旁沟转移 4例 ;大网膜转移 2例。 30例再分期手术阴性患者 (指再分期手术时没有发现残存肿瘤者 )中 ,3年和 5年生存率分别为 96 7%和 86 7% ;12例再分期手术阳性患者的 3年和 5年生存率分别为 12例中 7例和 12例中 3例。再分期手术的主要并发症是出血 (10 0 0 % ,出血量为 5 0～ 110 0ml,平均 2 80ml)和淋巴囊肿 (7 1% ) ,无围手术期死亡病例。结论 对初步诊断为早期卵巢癌的患者应进行全面的分期探查手术 ,初次手术时未进行全面的分期探查手术者应进行再分期手术。再分期手术阴性者预后好 ,易于治愈。再分期手术无严重并发症。
Objective To investigate the value of reoperation of ovarian cancer and its complications. Methods Forty-two patients were ovarian cancer patients who were diagnosed as stage Ⅰa-Ⅱa without complete exploration during the first operation of the hospital admitted from January 1986 to January 1996 in our hospital. There were 28 cases of stage Ia, 1 case of stage Ib, 12 cases of stage Ic and 1 case of stage IIa. There were 26 cases of ovarian epithelial carcinoma, 9 cases of malignant germ cell tumor and 7 cases of granular cell tumor. The first operation outside the hospital only ipsilateral attachment resection in 40 cases. Results In 12 of 42 patients (286%), stage was confirmed by re-staging, of which 8 (190%) were actually stage III patients. Of the 12 patients with positive re-staging (referring to those with residual tumor found in the re-staging surgery), 3 patients had cytological examination of ascites or peritoneal lavage fluid, 4 patients had colorectal gland metastasis, and 2 patients had omental metastasis. The 30-year and 3-year and 5-year survival rates were 96.7% and 86.7% respectively in patients with negative staging (no residual tumor was found when staging was retrospectively); 3 years and 5 The annual survival rates were 7 of 12 cases and 3 of 12 cases, respectively. The main complications of rescheplasty were hemorrhage (100%, blood loss 50-100ml, mean 280ml) and lymphatic cyst (7.1%), with no perioperative deaths. Conclusions Patients undergoing primary diagnosis of early stage ovarian cancer should undergo a comprehensive staging procedure. Patients who have not undergone full staging surgery at the time of initial surgery should undergo re-staging. Re-staging surgery negative prognosis, easy to cure. Reschedule surgery without serious complications.