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早期卵巢癌和输卵管癌的腹腔镜治疗：外科和生存预后
Laparoscopic management of early ovarian and fallopian tube cancers: surgical and survival outcome
Nezhat FR, Ezzati M, Chuang L  2009/5/27 10:50:39 
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Am J Obstet Gynecol, 2009,
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B
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Objective:
To evaluate the role of laparoscopy for staging of early ovarian cancers.

Study Design:
Case series conducted at the University Hospital with 36 patients who had presumed early-stage adnexal cancers. Laparoscopic staging/restaging was performed.

Results:
Cases included 20 invasive epithelial tumors, 11 borderline tumors, and 5 nonepithelial tumors. Mean number of peritoneal biopsies, paraaortic nodes, and pelvic nodes were 6, 12.23, and 14.84, respectively. Eighty-three percent of the patients had laparoscopic omentectomy. On final pathology, 7 patients were upstaged. Postoperative complications included 1 small bowel obstruction, 2 pelvic lymphoceles, and 1 lymphocele cyst. Mean duration of follow-up is 55.9 months. Three patients had recurrences. All patients are alive without evidence of the disease.

Conclusion:
This represents 1 of the largest series and longest follow-ups of laparoscopic staging for early-stage adnexal tumors. Laparoscopic staging of these cancers appears to be feasible and comprehensive without compromising survival when performed by gynecologic oncologists experienced with advanced laparoscopy.
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上腹痛20余天——上海中山病例

上海复旦大学附属中山医院消化科  刘黎黎  高虹

 

患者，男性，19岁，因“上腹痛20余天”于2005年12月15日入院。患者22天前开始出现中上腹持续剧烈疼痛，伴大便次数增多，3～4次/天，不成形，黑色，后出现呕吐，呕吐物为黄绿色胆汁样物质，有时低热，诊断性腹穿抽出少量淡血性液体，外院腹部平片示：小肠梗阻。查血见白细胞18.0×109/L，N 88.4%，尿蛋白(＋)，于12天前行剖腹探查术，术中见腹腔内有淡血性液体200 ml，见小肠节段性病变，未见肠坏死及穿孔，行腹腔冲洗引流术，术后予地塞米松、制酸、生长抑素、营养补液、抗感染治疗后，未见好转而转入我院。

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