当科における再発婦人科悪性腫瘍に対する腹腔鏡手術の後方視的検討

抄録

　Although cytoreductive surgery can be the first choice of treatment for recurrent gynecologic malignancies (RGM), the effectiveness and safety of laparoscopic surgery for these tumors are still controversial. We conducted a retrospective study of cytoreductive surgery for RGM in a single institution. A total of 44 patients underwent RGM surgery on 57 occasions from 2011 to 2017. Laparoscopic surgery was performed for 10 cases, of which 6 cases were lymph node recurrence, 3 cases were peritoneal dissemination of ovarian cancer, and 1 case was central pelvic recurrence of uterine leiomyosarcoma.

　In almost all of these cases, the recurrence site was single and the mass volume was small enough (1.4 ± 0.6 cm) to extract from the peritoneal cavity through a trocar.

　In the laparoscopic surgery group, the operation time was short (157 ± 67.1 minutes), blood loss was small (55.5 ± 116 g), and length of stay was short (4.7 ± 1.5 days). Tumors were completely excised in all 10 laparoscopic cases, and there were no cases changed to laparotomy. During the postoperative observation period of 25.8 months on average, recurrence was observed in 4 cases but there were no deaths in the laparoscopic surgery group.

In the management of RGM, if the case is properly selected, laparoscopic surgery may be minimally invasive without compromising oncological prognosis.