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华西医学  2015 

卵巢交界性肿瘤腹腔镜术后发生穿刺孔转移并文献复习

DOI: 10.7507/1002-0179.20150133, PP. 468-472

Keywords: 穿刺孔转移,腹腔镜,卵巢交界性肿瘤

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Abstract:

目的?总结卵巢交界性肿瘤(BOT)患者腹腔镜术后发生大面积穿刺孔转移(PSM)的临床特点,并就腹腔镜治疗BOT的安全性、可行性及化学疗法(化疗)能否使BOT患者受益进行探讨。方法?对2013年8月收治的1例腹腔镜术后发生大面积PSM的微乳头型BOT患者的临床资料进行分析,以“穿刺孔转移”、“卵巢交界性肿瘤”、“腹腔镜”、“化疗”为主题词检索1929年-2014年PubMed、Cochrane等数据库中有关文献。结果?患者在保守手术及紫杉醇联合顺铂方案化疗8次后,腹壁包块及肿瘤标志物较前无明显改善。虽有文献报道早期卵巢癌和BOT进行腹腔镜手术是安全、有效的,但仍无高质量证据支持腹腔镜是处理早期卵巢癌的常规实践。且化疗是否使BOT患者受益存在争议。结论?开腹手术仍是治疗卵巢肿瘤的金标准,对于低危和要求微创者,可选择腹腔镜手术,但应按指南行全面分期手术,对于腹腔镜术困难或发现高危者,应立即转行或尽快行开腹分期手术,手术应由经验丰富的妇科肿瘤医生完成,并对于高风险者术后给予化疗,行长期随访。

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