Surgical treatment of ovarian cancer

By | April 18, 2012

Comprehensive treatment of ovarian cancer is often used, but the most fundamental and most important treatment is still surgery.
1. Surgical treatment of ovarian cancer indications and contraindications.
(1) indications from the modern point of view of gynecologic oncology, ovarian cancer surgery options are nearly limitless, the vast majority of cases, especially the initial treatment, are surgically removed.
(2) relative contraindications extensive infiltration of tumor cells makes the most of the tumor tissue wrapped in intestines, mesenteric curled or disappeared. large pleural effusion serious impact on respiratory and circulatory function, is difficult to tolerate a major surgery. severe uremia, liver disease, severe cerebral vascular accident and so on.
2. Surgical
(1) laparotomy, unilateral oophorectomy for attachment or ovarian cancer, surgical resection of the affected side range of accessories or ovaries, omentum and retroperitoneal lymph nodes, contralateral ovarian biopsy probe profile, peritoneal cytology and high risk area (uterus rectum nest, colon side ditch, mesentery, transverse chest, omentum, retroperitoneal lymph node) biopsy probe, should ensure that the pathological negative resection margin.
(2) exploratory laparotomy, total hysterectomy, double attachment, omentum and appendix of the surgical resection of ovarian cancer in general the basic procedure, and for early ovarian cancer, tumor confined to the net and basically can be cut. Abdominal surgery ranges from ascites or peritoneal washing after sending cytology, exploration, and if necessary, biopsy breast, liver, large intestine, mesentery, peritoneum, omentum, retroperitoneal lymph nodes and pelvic attachments, rectum, bladder and pelvic peritoneum and so on, while hysterectomy, two annexes and omentum removed.
(3) a comprehensive staging laparotomy to determine the surgical procedures for early ovarian cancer or pelvic cancer confined to the net who can cut basically. At the same time hysterectomy, two attachments, omentum, appendectomy, and pelvic and aortic lymph nodes (up to the level of the inferior mesenteric artery) dissection.
(4), laparotomy, cytoreductive surgery is mainly used for the surgical patients with advanced ovarian cancer. Principles of the present can not be successful if most of the tumor resection, may be appropriate to reduce the extent of surgery, organ damage in conditions not to be as much as possible removal of the primary tumor and metastases. Surgery, including straight incision large enough, the line ascites or peritoneal washing cytology, biopsy probe or multi-point probe breast removed, the colon side of the ditch, pelvic wall peritoneum, rectum, mesentery and uterine fossa, proper treatment of liver metastases and spleen metastasis the same time, hysterectomy, or pelvic tumor resection double attachment, ovarian vein ligation and excision from the lower edge of the greater omentum transverse colon (hepatic flexure of attention, at the splenic flexure), abdominal aortic and pelvic lymph node dissection to remove the appendix and treatment of intestinal transfer.
(5) second exploratory surgery for ovarian cancer patients after the satisfaction of the success of cytoreductive surgery within a year, and because the purposes for at least six courses of chemotherapy, assisted by clinical or physical examination and laboratory tests, no Signs of tumor recurrence. But that the malignant germ cell tumors, sex cord stromal tumor, borderline tumor, I may be of epithelial tumors, "the second probe." Abdominal surgery, including 2 were washed, the right fossa and pelvic colon lavage cytology delivery, careful exploration of pelvic floor, the colon side of the ditch bilateral pelvic wall, bladder fossa, rectal fossa, omentum and pelvic ligaments funnel roots, mesenteric , intestinal serosa and retroperitoneal lymph nodes, and suspicious Department for biopsy. Can be organized under conditions of estrogen receptor, progesterone receptor and oncogenes, tumor suppressor gene detection.
(6) palliative surgery for advanced ovarian cancer, intestinal obstruction. General surgery or a thin line of making purposes under the site of obstruction client – side anastomosis, side – side anastomosis or T-tube made thin. Surgery aims to relieve obstruction, to resolve the pain of patients and prolong survival.
3. Surgical complications
Possible infection of ovarian cancer surgery, organ (such as the ureter, bowel, bladder, etc.) damage, bleeding, abdominal cavity may occur after infection, adhesions, intestinal thin, thin ureter, pelvic, or surgical site bleeding, hematoma, syndrome, and wound liquefaction, infection, hematoma, and dehiscence. Therefore, surgery should be carefully dissected and exposed clearly, prevention of infection, complete hemostasis, to avoid organ injury, postoperative management syndrome, in order to avoid complications.

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