Background/Objectives:Douglasectomy is defined as the removal of the pelvic peritoneum of the entire pouch of Douglas. In presumed FIGO stage I ovarian cancer, isolated microscopic cancer cells might disseminate from the ovaries to their neighboring pelvic peritoneum. However, a simple hysterectomy with bilateral salpingo-oophorectomy and a staging procedure is the standard of care. This study aims to investigate the safety and feasibility of douglasectomy compared to random pelvic biopsies, and it is based on the survival of patients with early ovarian cancer.Methods:We retrospectively analyzed the records of patients with presumed 2018 FIGO stage I ovarian cancer who underwent surgery in the 1st Department of Obstetrics and Gynecology Clinic from 2012 to 2022. Patient characteristics and oncological and follow-up information were collected.Results:A total of 88 patients were categorized into two groups, namely Group A (27 patients) with douglasectomy and Group B (61 patients) with random biopsies. There was no statistically significant difference in age, BMI, comorbidities, FIGO stage, intraoperative blood loss, and ICU admittance between the two groups. Conversely, patients with en bloc hysterectomy–douglasectomy had statistically significant higher pre-operative CA-125 values, surgery duration, rate of postoperative complications, and hospital stay. Concerning survival rates, there was a statistically significant difference in disease-free survival (p= 0.033), but no difference was observed in overall survival (p= 0.66).Conclusions:En bloc removal of the pelvic peritoneum of the entire pouch of Douglas with the uterus is a safe and feasible technique during surgery for early ovarian cancer, which leads to improved disease-free survival and local control.
背景/目的：道格拉斯切除术定义为完整切除道格拉斯窝的盆腔腹膜。在推测为FIGO I期卵巢癌中，孤立的微观癌细胞可能从卵巢扩散至邻近的盆腔腹膜。然而，单纯子宫切除加双侧输卵管卵巢切除术及分期手术是目前的标准治疗方案。本研究旨在基于早期卵巢癌患者的生存数据，比较道格拉斯切除术与随机盆腔活检术的安全性和可行性。 方法：我们回顾性分析了2012年至2022年间在第一妇产科诊所接受手术、推测为2018年FIGO I期卵巢癌患者的病历资料，收集了患者特征、肿瘤学信息及随访数据。 结果：共88例患者分为两组：A组（27例）接受道格拉斯切除术，B组（61例）接受随机活检术。两组在年龄、BMI、合并症、FIGO分期、术中失血量及ICU入住率方面无统计学显著差异。相反，接受子宫-道格拉斯窝整块切除术的患者术前CA-125值、手术时长、术后并发症发生率及住院时间均显著更高。在生存率方面，无病生存期存在统计学显著差异（p=0.033），但总生存期未见差异（p=0.66）。 结论：在早期卵巢癌手术中，整块切除子宫及道格拉斯窝盆腔腹膜是一种安全可行的技术，可提高无病生存率并改善局部控制效果。
肿瘤(癌症)患者之家