METHOD FOR SURGICAL TREATMENT OF PATIENTS WITH DISEASED OVARIAN CANCER

摘要

The invention relates to medicine, namely to oncology, operative gynecology, and concerns a method of surgical treatment of patients with advanced ovarian cancer. The objective of the claimed invention is to create a new method of surgical treatment of patients with advanced ovarian cancer. The method of surgical treatment of patients with advanced ovarian cancer is that the conglomerate consisting of tumors of the ovaries, uterus, uterine ligaments, pelvic peritoneum and parametrial tissue is mobilized by retroperitoneal access and removed in a single block from the upper third of the vagina. The cardinal and sacro-uterine ligaments are crossed at the walls of the pelvis without affecting the lower hypogastric plexus (plexus hypogastricus inferior). The vesicouterine ligaments are transected at the bladder wall, the uterine artery and vein are transected at the level of their discharge from the internal iliac artery and vein, the pelvic and para-aortic lymph nodes are also removed completely in a single block - total para-aortic and iliac lymph node dissection. Treatment according to the claimed method was carried out in 36 patients with ovarian cancer stage IIC-IV. Of these, 5 (13.8%) - stage II, 30 (83%) - III and 1 (2.7%) - IV stage of the disease. Surgical treatment was performed in 18 patients after neoadjuvant chemotherapy, in 18 patients immediately after diagnosis. After surgery, all patients received chemotherapy (CP). The average age of the patients was 54.6 g (from 24 to 82 years). Complete cytoreduction was achieved in 27 patients (75.7%), optimal cytoreduction (residual tumor size from 0.1 to 0.5 cm in diameter), in 9 patients (24.3%) - surgery. Thus, all patients were operated on in the optimal volume. Relapse of the disease was detected on average after 24.8 months (from 9 to 42 months); was detected by MRI and ultrasound and the level of CA-125 in the blood. The inventive method makes it possible to achieve a 5-year overall survival rate of 96 ± 3.9% and a 5-year disease-free survival rate in 76.1 ± 11.3% of patients with advanced ovarian cancer. The median follow-up was 67 ± 5.1 months.