卵巢癌肿瘤细胞减灭术中脾脏切除的手术探究

目的探讨晚期和复发的上皮性卵巢癌减瘤术中脾脏切除术的必要性和可行性。方法回顾分析首次（5例）或再次细胞减灭术（7例）中施行脾脏切除术的12例晚期卵巢癌患者的临床资料。结果12例患者的平均总生存期为37．75个月（15个月-65个月），3年总生存率为58．33％（7／12）；7例生存至今的患者中2例无瘤生存，分别生存3年和3．5年，三年无瘤生存率为16．67％（2／12）。手术并发症发生率25％（3／12），与脾切除直接相关的手术并发症发生率为8．33％（1／12）。获得满意减瘤术的9例患者和不满意减瘤术的3例患者的平均总生存期分别为43．33个月和21个月（t=3．215，P〈0.05），有显著性差异。结论晚期或复发的卵巢癌肿瘤细胞减灭术时为达到满意的手术对脾脏转移者施行脾脏切除是必要和可行的。

Feasibility of splenectomy in cytoreduction for epithelial ovarian carcinoma

Objective To investigate feasibility and necessity of splenectomy with tumor cytoreduction for advanced or recurrent epithelial ovarian carcinoma. Methods Seven cases undergoing splencctomy as part of primary cytoreduction（5 cases）or secondary cytoreduction（7 cases）were analyzed retrospectively. Results Of the 12 cases ,mean survival was 37.75 months（ 13 -65months）from the initial diagnosis ,3 -year overall survival rate was 58.33% （7/12） ;3 - year disease free survival rate was 16.67% （2/12）. Post operation complication rate was 25% （3/12）, and the preoperative complications related to splenectomy was 8.33% （ 1/12）, the mean survival from initial diagnosis in optimal cytoreduction （ 7 cases ） and suboptimal Cytoreduction （ 5 cases ） was 43.33 months and 21 months （t = 3. 215 ,P 〈 0. 05 ）respectively. There was significant difference in survival between these two groups. Conclusion In order to get optimal cytoreduction for advanced and recurrent ovarian carcinoma,it is necessary and feasible to perform splenectomy for spleen metastasis.