Application Value Of Laparoscopy In The Diagnosis And Treatment Of Advanced Ovarian Malignant Tumor

Objective: to evaluate the value of laparoscopy in the diagnosis and treatment of advanced ovarian malignancy.Methods: a total of 39 patients with suspected advanced ovarian malignancy admitted to the gynecological center of Qingdao municipal hospital in shandong province from January 2016 to December 2018 were selected for laparoscopic diagnosis and treatment(laparoscopic diagnosis--evaluation--clinical decision--reevaluation),and 19 cases were treated with traditional laparotomy.The diagnosis and treatment procedures of laparoscopy are as follows :(1)laparoscopy,ascites cytology,pelvic multi-point biopsy and tumor tissue gene sequencing;(2)laparoscopic staging and PIV scoring were performed.(3)clinical decision-initial tumor cell depletion(laparoscopic or laparoscopic),intermediate tumor cell depletion(laparoscopic or laparoscopic)or other treatment.The diagnostic accuracy,satisfaction rate of tumor cell subtraction,operative time,operative blood loss,incidence of surgical complications,number of lymph node dissection and postoperative exhaust time were compared and analyzed.Results: there was no significant difference in age,clinical stage,pathological type and differentiation between the laparoscopic treatment group and the open treatment group(P > 0.05).The preoperative diagnostic accuracy was 100% in the laparoscopic group and 78.95% in the open group,with statistical difference(P < 0.05).Among the 39 patients in the laparoscopic treatment group,36 patients were evaluated for surgical treatment under laparoscopy(laparoscopic or laparoscopic initial tumor cell subtraction or intermediate tumor cell subtraction),and the satisfaction rate of tumor cell subtraction was 83.33%.Among the 19 patients in the open treatment group,10 were satisfied with tumor cell subtraction,and the satisfaction rate of tumor cell subtraction was 52.63%.The satisfaction rate of ovarian tumor cell reduction surgery in the laparoscopic treatment group was higher than that in the open surgery group,and the difference was statistically significant(P < 0.05).There were statistically significant differences between the laparoscopic diagnosis and treatment group and the open diagnosis and treatment group in operation time,operative blood loss,surgical complication rate,postoperative exhaust time,etc.(P < 0.05),but no significant differences in the number of lymph node dissection(P > 0.05).Conclusion: laparoscopy has obvious advantages in the diagnosis,evaluation and treatment of selected patients with advanced ovarian cancer.It has advantages of high diagnostic accuracy,less intraoperative bleeding,less surgical complications and rapid postoperative recovery.The satisfaction rate of initial tumor cell reduction surgery after laparoscopic evaluation and intermediate tumor cell reduction surgery after neoadjuvant chemotherapy was higher than that of traditional open surgery.However,due to the small number of samples in this study and the short follow-up time,it is necessary to expand the sample size for further study and demonstration.