| 周 芳,陈 烽,潘 婷.晚期上皮性卵巢癌行经膈心膈角淋巴结切除的安全性及可行性分析[J].肿瘤学杂志,2021,27(11):946-951. |
| 晚期上皮性卵巢癌行经膈心膈角淋巴结切除的安全性及可行性分析 |
| Safety and Feasibility of Transdiaphragmatic Cardiophrenic Lymph Node Resection for Advanced Epithelial Ovarian Cancer |
| 投稿时间：2021-06-08 |
| DOI：10.11735/j.issn.1671-170X.2021.11.B009 |
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| 中文关键词: 上皮性卵巢癌 肿瘤细胞减灭术 经膈心膈角淋巴结切除术 并发症 |
| 英文关键词:epithelial ovarian cancer primary debulking surgery transdiaphragmatic cardiophrenic lymph node resection complication |
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| 中文摘要: |
| 摘 要：［目的］ 探讨晚期上皮性卵巢癌患者行经膈心膈角淋巴结切除的安全性及可行性。［方法］ 选择2017年1月至2019年12月在中国科学院大学附属肿瘤医院（浙江省肿瘤医院）行心膈角淋巴结切除术的28例原发性上皮性卵巢癌患者为研究对象，回顾性分析患者的临床、病理、手术及并发症等资料。［结果］ 28例行经膈心膈角淋巴结切除术的患者均达到满意减瘤，其中15例（53.6%）患者达到无肉眼残留。心膈角淋巴结转移术前影像学与术后病理诊断的一致率为96.3%。所有患者均同时接受了横膈腹膜/膈肌部分切除，仅有3例（10.7%）患者术中放置胸腔引流管，术后22例（78.6%）患者出现中-大量的胸腔积液，经胸腔穿刺置管引流后均得到好转，中位拔管时间3 d。其他与心膈角淋巴结切除相关的常见并发症如气胸、肺炎、胸膜炎等未发现。［结论］ 对于术前影像学提示心膈角淋巴结转移的晚期上皮性卵巢癌患者，若腹腔内病灶可达到满意减瘤，可采用经膈入路的心膈角淋巴结切除术，该方法可行且安全；若同时行横膈腹膜/膈肌切除术，建议术中常规放置胸腔引流管，减少术后胸腔穿刺置管率。 |
| 英文摘要: |
| Abstract：［Objective］ To investigate the safety and feasibility of transdiaphragmatic cardiophrenic lymph node(CPLNs) resection for advanced epithelial ovarian cancer(EOC). ［Methods］ From January 2017 to December 2019， 28 patients with advanced primary epithelial ovarian cancer underwent transdiaphragmatic cardiophrenic lymph node resection at the Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital). The clinical， pathological， surgical data and complications were analyzed. ［Results］ All patients achieved optimal tumor reduction， and 15 patients(53.6%) achieved no gross residual. The accuracy of preoperative imaging diagnosis was 93.1%. Patients underwent diaphragm peritonectomy/full-thickness resection at the same time. Three patients(10.7%) had a pleural drainage tube placed during the operation， and 22 patients(78.6%) had moderate to large pleural effusions after the operation， which were cured after transthoracic drainage， and the median extubation time was 3 days. There were no other major complications such as pneumothorax， pneumonia and pleurisy in this study. ［Conclusion］ The cardiophrenic lymph node resection through the diaphragmatic approach is feasible and safe for patients with advanced epithelial ovarian cancer. It is recommended to place thoracic drainage tube during operation to reduce the rate of thoracic puncture tube after operation. |
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