Retrospective Analysis Of 88 Cases Of Ovarian Neoplasms Undergoing Supplementary Surgery

Objective:To evaluate the value and risk of supplementary surgery in patients with ovarian neoplasms without comprehensive staging.Methods:The clinical data of ovarian neoplasms with initial operation without comprehensive staging in foreign hospital that treated in Shanxi Cancer Hospital from 2012 to 2016 were retrospectively analyzed.To summarize the causes of incomplete staging in the first operation;to calculate the positive rate of pathology after supplementary surgery and tumor residual site;to calculate the anastomosis rate of preoperative imaging,tumor markers and postoperative pathology;to sum up the intraoperative situation of supplementary surgery,postoperative complications;to study related situation about tissue adhesion of supplementary surgery.χ 2 test and t test were used for statistical analysis.Results:The main causes of incomplete staging of primary operation were no frozen pathology and technical limitation of doctors in the grass-roots hospital.65 cases of epithelial ovarian carcinoma,31 cases were pathologically positive after supplementary surgery(positive rate 47.7%).13 cases of sex cord stromal tumor,1 case of pathological positive after supplementary surgery(positive rate 7.6%).3 cases of germ cell tumor,1 case of pathological positive after supplementary surgery(positive rate 1/3).7 cases of borderline ovarian tumor,2 cases of pathological positive after supplementary surgery(positive rate 2/7).The anastomosis rate between preoperative ultrasound and postoperative pathology was 17/24(70.8%).The anastomosis rate between CT and postoperative pathology was 2/5.The anastomosis rate of tumor markers between preoperative and postoperative pathology of epithelial carcinoma was 12/22(54.5%).The main complications of the second operation were wound liquefaction and poor healing(4.5%)and infection(5.7%).In 88 patients with supplementary surgery,48 patients with tissue adhesion(54.5%),11 of them had severe adhesions(affecting the operation of the operation).If the first operation was open surgery,the tissue adhesion rate was 69.6%.If the first operation is laparoscopic,the tissue adhesion rate is 28.1%.χ 2 test had statistical significance(p < 0.05).Conclusion:The patients with ovarian epithelial carcinoma with incomplete initial stage should be treated by supplementary surgery,and further treatment should be made according to the stage of supplementary surgery.To sex cord-stromal tumor,germ cell tumor,borderline tumor,whether or not to undergo supplementary surgery,comprehensive consideration to develop individualized schemes.The results of preoperative imaging and tumor markers can provide meaningful guidance on whether or not to perform supplementary surgery.The problem of tissue adhesion in the second operation does increase the difficulty of the operation.Laparoscopic surgery for the first time can reduce the incidence of adhesion,in addition,choosing the appropriate time to supplement surgery may reduce the incidence of adhesion.