What does cytoreductive surgery mean?

summary

Tumor reductive surgery refers to the operation in which the larger tumor or tumor produces some obvious compression symptoms, the tumor can not be completely removed, and the symptoms can be alleviated by removing part of the tumor. Let's share my experience with you.

What does cytoreductive surgery mean?

After abdominal incision, the quantity, color and nature of ascites should be noted, and the ascites should be taken for cytological examination. If there is no ascites, 100-200ml normal saline can be used to wash the diaphragm, paracolonic sulcus, uterine and rectal fossa from top to bottom, and cytological examination can be done after recovery.

First check whether the ovarian tumor is primary or secondary, unilateral or bilateral, solid or cystic; Whether the capsule is complete or not; Whether there is rupture or not; The relationship with the surrounding tissues and organs, such as fallopian tube, uterus, bladder, rectum, whether there is adhesion, whether it is infiltrated. Even in the early stage, there may be cancer metastasis, and the high-risk areas such as right diaphragm, omentum, peritoneum, para aortic lymph nodes and pelvic lymph nodes should be carefully examined. In suspicious areas, including adhesion, coarseness and nodules, biopsy should be performed respectively.

The blood supply of ovarian cancer comes from the retroperitoneum. The ligation of ovarian blood vessels must be firm. First, ligation with No. 10 silk thread, then ligation with No. 7 silk thread at the proximal end. If possible, the primary ovarian cancer should be removed first, which is beneficial to the exposure of the pelvic cavity and the operation. If it cannot be removed temporarily, it should be removed together with the implanted metastatic tumor and uterine appendages.

matters needing attention

Ovarian cancer is prone to abdominal aorta and pelvic lymph node metastasis, stage III and IV retroperitoneal lymph node metastasis accounted for 50% - 80%. Especially in 1986, the International Union of Obstetrics and Gynecology established a new clinical stage, which can be divided into Ⅲ a, Ⅲ B and Ⅲ C according to the presence or absence of retroperitoneal lymph node metastasis. They should be divided into groups according to the lymphatic drainage area of the cancer focus and resected in a piece, complete and systematic way.