周 芳,陈 烽,朱 滔,等.泌尿系手术在晚期卵巢癌肿瘤细胞减灭术中的应用205例分析[J].肿瘤学杂志,2022,28(7):545-550.
泌尿系手术在晚期卵巢癌肿瘤细胞减灭术中的应用205例分析
Urinary Tract Involvement in Cytoreductive Surgery for 205 Patients with Advanced Epithelial Ovarian Cancer
投稿时间:2021-10-14  
DOI:10.11735/j.issn.1671-170X.2022.07.B003
中文关键词:  卵巢癌  肿瘤细胞减灭术  输尿管膀胱再植术  输尿管端端吻合术
英文关键词:epithelial ovarian cancer  cytoreductive surgery  re-implantation uretero-neocystostomy  end-to-end ureteral anastomosis
基金项目:浙江省教育厅一般科研项目(Y202044441);浙江省公益技术应用研究项目(LGF21H160008);浙江省中医药重点研究项目(2021ZZ007)
作者单位
周 芳 浙江中医药大学第二临床医学院 中国科学院大学附属肿瘤医院(浙江省肿瘤医院)中国科学院基础医学与肿瘤研究所 
陈 烽 浙江中医药大学第二临床医学院 
朱 滔 中国科学院大学附属肿瘤医院(浙江省肿瘤医院)中国科学院基础医学与肿瘤研究所 
潘 婷 浙江中医药大学第二临床医学院 中国科学院大学附属肿瘤医院(浙江省肿瘤医院)中国科学院基础医学与肿瘤研究所 
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中文摘要:
      摘 要:[目的] 探讨泌尿系手术在晚期卵巢癌肿瘤细胞减灭术中的安全性及可行性。[方法] 选择2011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)行含泌尿系修补和切除的初次肿瘤细胞减灭术的205例晚期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] 172例(83.9%)患者进行泌尿系修补手术,33例(16.1%)患者进行泌尿系切除手术,47例(22.9%)患者术中放置输尿管双J支架。手术时间中位数为390(323,445) min,出血量中位数为800(500,1 200) mL,输血率为85.4%。187例(91.2%)患者术后达到满意减瘤。术后3~4级并发症发生率为38.1%,尿路感染8例(3.9%),尿瘘4例(2.0%)(3例行膀胱修补术后出现膀胱瘘,1例行输尿管修补术后出现输尿管瘘),输尿管狭窄1例,无围手术期死亡。165例(80.5%)完成6个疗程及以上的标准方案化疗,中位无进展生存期为19个月,5年无进展生存率为37.1%。[结论] 卵巢癌肿瘤细胞减灭术中行泌尿系手术安全可行,并发症可控,在可达到满意减瘤术的情况下可常规开展。
英文摘要:
      Abstract: [Objective] To explore the safety and feasibility of urinary tract involvement in cytoreductive surgery for advanced epithelial ovarian cancer. [Methods] The clinical data of 205 patients with advanced ovarian cancer who underwent primary cytoreductive surgery with urinary tract repair or resection in the Cancer Hospital of the University of Chinese Academy of Sciences from January 2011 to December 2019 were retrospectively analyzed. [Results] Among 205 patients, 172(83.9%) underwent urinary tract repair, 33(16.1%) underwent urinary tract resection, and 47(22.9%) received ureteral double J stents. The median operation time was 390(323, 445) min, the median blood loss was 800(500, 1 200) mL, and the blood transfusion rate was 85.4%, and 187 patients(91.2%) achieved optimal cytoreduction. The incidence of postoperative complications of grade 3 to 4 was 38.1%, there were 8(3.9%) cases of urinary tract infection, 4(2.0%) cases of urinary fistula, 1 case of ureteral stricture, no perioperative death. One hundred and sixty five patients(80.5%) completed 6 cycles or more of standard chemotherapy. The median progression-free survival(PFS) was 19 months, and the 5-year PFS rate was 37.1%. [Conclusion] Urinary tract involvement during cytoreductive surgery for ovarian cancer is safe and feasible with controllable complications, and it can be performed routinely when satisfactory cytoreductive surgery is achieved.
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