2023 年 39 巻 1 号 p. 21-27
Objective: This study aimed to investigate the usefulness of intraoperative cell-free and concentrated ascites reinfusion therapy (CART) in patients undergoing diagnostic laparoscopic surgery of advanced ovarian or peritoneal cancer (AOPC) with massive ascites.
Methods: We retrospectively compared the background characteristics and post operative course between 11 patients with AOPC who underwent CART during diagnostic laparoscopic surgery (CART group) and 11 patients with AOPC who did not undergo intraoperative CART (non-CART group). The method of CART was as follows: Ascites was aspirated using a 12-French gauge catheter placed through a laparoscopic port; after the laparoscopic procedure, filtered and concentrated ascites was intravenously administered to the patients at a rate of 100 ml/h.
Results: The operation time was longer in the CART group than in the non-CART group (71 vs. 58 min, p=0.02). The CART group maintained adequate urine output without diuretics or albumin administration after surgery. The postoperative change in the serum albumin level was ±0.0 g/dl in the CART group and -0.7 g/dl in the non-CART group, and the difference between groups was statistically significant (p=0.02). One patient developed a fever during the reinfusion of ascites; however, no patient experienced any adverse effects or a delay in the start of adjuvant chemotherapy because of CART.
Conclusion: CART during diagnostic laparoscopic surgery is beneficial for the management of patients with AOPC.
