目的

探讨晚期卵巢癌新辅助化疗（neoadjuvant chemotherapy，NACT）后行腹腔镜下间歇性肿瘤细胞减灭术（interval debulking surgery，IDS）患者的选择及手术技巧。

方法

收集符合标准的接受腹腔镜下IDS 术的晚期卵巢癌患者的临床、手术、病理及随访资料。

结果

自2023年3月至12月，南京医科大学第一附属医院妇科共6 例患者经过3 疗程NACT 后，接受了腹腔镜下IDS，均达R0 切除，平均手术时间405 ±42 min，平均出血量283 ±194 ml。 2 例患者因术前合并中度贫血、术中出血＞400 ml，接受了输血。 术后首次化疗距IDS 的中位时间为13 d。 术后30 d 内均无Clavien-DindoⅡ级及以上的并发症发生。 经中位随访6 个月，无复发与死亡。

结论

腹腔镜下IDS 可选择经充分评估的患者，由具有丰富的开腹肿瘤细胞减灭术经验和良好腹腔镜手术技巧的术者完成，实现满意减瘤，同时减少创伤，促进术后恢复。

Objective

To study the appropriate patient selection and surgical techniques for laparoscopic interval debulking surgery （IDS） after neoadjuvant chemotherapy （NACT） for advanced ovarian cancer.

Methods

The clinical，surgical，pathological and follow-up data were collected from patients with advanced ovarian cancer who met the criteria and underwent laparoscopic IDS after NACT.

Results

From Mar. 2023 to Dec. 2023，six patients underwent laparoscopic IDS after 3 courses of NACT at the department of gynecology，The First Affiliated Hospital of Nanjing Medical University，and all of them achieved R0 resection with a mean operative time of 405 ±42 minutes and intraoperative bleeding of 283 ±194 ml. Two patients were transfused due to preoperative moderate anemia and intraoperative bleeding of more than 400 ml. The median interval between the first postoperative chemotherapy and IDS was 13 days. None of the patients suffered from Clavien-Dindo grade Ⅱor higher complications within 30 days after surgery. After 6 months of follow-up，no patient had recurrence or died.

Conclusions

Laparoscopic IDS allows for the selection of adequately evaluated patients and is performed by an operator with extensive experience in open cytoreduction surgery and good laparoscopic surgical skills，achieving satisfactory tumor reduction while reducing trauma and facilitating postoperative recovery.