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目的 分析复发性卵巢癌患者合并肠梗阻行姑息性手术治疗的临床应用。方法 回顾分析 1997～ 2 0 0 2年采用姑息性手术治疗 (手术治疗 )的 6 7例复发性卵巢癌合并肠梗阻患者 ,并与同期未行手术治疗 (非手术治疗 )的 75例复发性卵巢癌合并肠梗阻患者进行比较。采用COX回归分析法 ,分析行手术治疗患者选择的参考指标。结果 手术治疗的 6 7例患者中 ,5 8例 ( 86 6 % )完成预期手术操作 ,4 3例症状获得成功缓解 ,缓解率 6 4 2 % ( 4 3/6 7) ,占所有肠梗阻患者的 30 3% ( 4 3/14 2 )。6 7例患者的中位数生存期为 7 8个月 ,4 3例症状获得成功缓解患者的中位数生存期为 12 6个月 ;非手术治疗患者的中位数生存期为 3 7个月。 6 7例患者的围手术期死亡率为 6 0 % ( 4 /6 7) ,并发症发生率为 2 2 4 % ( 15 /6 7)。单纯结肠发生梗阻和复发肿块位于盆腔 ,可作为采用手术治疗患者选择的参考指标。结论 采用姑息性手术治疗复发性卵巢癌合并肠梗阻 ,可使约 1/3的患者获得较好疗效 ;而选择恰当的患者 ,是手术治疗的关键
Objective To analyze the clinical application of palliative surgery in patients with recurrent ovarian cancer complicated with ileus. Methods A retrospective analysis was performed on 67 patients with recurrent ovarian cancer and intestinal obstruction who underwent palliative surgery (surgical treatment) between 1997 and 2002 and compared with 75 patients with recurrent ovarian failure who underwent surgery (nonsurgical treatment) Patients with cancer complicated with ileus were compared. The COX regression analysis was used to analyze the selection of patients for surgical reference. Results Of the 67 patients undergoing surgical treatment, 58 (86.6%) completed the prospective surgical procedures and 43 patients achieved successful relief with a response rate of 64.2% (4 3/6 7) Of 30 3% (4 3/14 2). Sixty-seven patients had a median survival of 78 months and a median of 43 patients who achieved successful remission had a median survival of 12.6 months. The median survival of nonsurgical patients was 37 month. The perioperative mortality rate was 60% (4/67) in 67 patients, and the complication rate was 224% (15/67). Simple colorectal obstruction and recurrent mass located in the pelvic cavity, can be used as a reference choice for surgical treatment of patients. Conclusion Palliative surgery for recurrent ovarian cancer with intestinal obstruction, can make about 1/3 of patients get better curative effect, and the right choice of patients is the key to surgery