Intraperitoneal Chemotherapy by Ultrasound-Guided Direct Puncture in Recurrent Ovarian Cancer Feasibility, Compliance, and Complications
Intraperitoneal Chemotherapy by Ultrasound-Guided Direct Puncture in Recurrent Ovarian Cancer Feasibility, Compliance, and Complications
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DOI：
10.1097/igc.0b013e31825736b2
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发表时间：
2012-07-01
影响因子：
4.8
通讯作者：
Bellati, Filippo
中科院分区：
文献类型：
--
作者：
Benedetti-Panici, Pierluigi;Perniola, Giorgia;Bellati, Filippo
目的：这项前瞻性预研究探讨了在超声引导下对连续复发性卵巢癌（ROC）患者进行直接穿刺腹腔（IP）化疗的可行性、并发症和依从性。方法：对患者进行二次细胞减灭术和/或接受IP化疗的评估。患者在超声引导下接受ROC标准静脉治疗加直接穿刺针IP给药。结果：2008年1月至2011年1月，入组38例患者。总共进行了 402 次 IP 手术，平均每位患者进行 10.5 次手术。可行性率为97.4%。在亚组 1（腹壁厚度 6 cm）的 237 例（98.8%）中，需要进行 1 次以上的尝试（P < 0.01）。平均手术时间为 10 分钟（范围为 5-30 分钟）。我们总共记录了 2.25% 的轻度术中并发症。根据腹壁厚度或既往剖腹手术次数，并发症发生率没有显着差异。共有 5 例（1.2%）因患者不配合而未进行手术。根据视觉模拟疼痛量表，首次评估时（3分钟后）平均疼痛评分为中度，最终评估时（10分钟后）为轻度。结论：超声引导下直接穿刺IP化疗对于ROC患者是一种安全可行的方法，患者接受度较高。
Objective: This prospective pilot study investigated the feasibility, complications, and compliance of the administration of intraperitoneal (IP) chemotherapy by direct puncture under ultrasonographic guidance performed on consecutive patients with recurrent ovarian cancer (ROC).Methods: Patients were evaluated to undergo secondary cytoreduction and/or to receive IP chemotherapy. Patients received standard intravenous therapy for ROC plus IP administration by direct puncture needle, under ultrasonographic guidance.Results: From January 2008 to January 2011, 38 patients were enrolled. A total of 402 IP procedures were performed, with a mean of 10.5 procedures per patient. The feasibility rate was 97.4%. In 237 cases (98.8%) of subgroup 1 (abdominal wall thickness 6 cm), more than 1 attempt was necessary (P < 0.01). The mean procedure time was 10 minutes (range, 5-30 minutes). We recorded a total of 2.25% mild intraprocedure complications. No significant difference was identified for the complication rate according to the abdominal wall thickness or according to the number of previous laparotomies. A total of 5 procedures (1.2%) were not performed as a result of patients' noncompliance. The mean pain score according to the visual analog pain scale was moderate at the first evaluation (after 3 minutes) and mild at the final evaluation (after 10 minutes).Conclusions: The administration of IP chemotherapy with a direct puncture, under ultrasound guidance, for patients with ROC, is a safe and feasible method, with a high acceptance from patients.