Abstract：
OBJECTIVE: To describe the surgical technique, assess feasibility, efficacy, and safety of peritonectomy and/or resection of mesentery (P-Rme) during Visceral-Peritoneal Debulking (VPD) in patients with stage IIIC-IV ovarian cancer (OC).
METHODS: In April 2009 we registered a protocol study on the safety and feasibility of P-Rme. In the period April 2009-December 2022, 687 patients with FIGO stage IIIC-IV ovarian cancer underwent VPD. One hundred and twenty-nine patients (18.7%) had extensive disease on the mesentery and underwent P-Rme. Feasibility was assessed as the number of procedures completed. Efficacy was measured as the rate of Complete Resection (CR). Safety was defined by the intra- and post-operative morbidity rate specifically associated with these procedures.
RESULTS: In all patients P-Rme was successfully completed. P-me was performed in 82 patients and R-me in 47, both procedures in 23 patients. CR was achieved in all 129 patients with an efficacy of 100%. Intra-operatively 5 patients out of 129 experienced small bowel loop surgical devascularization. They required small bowel resection and anastomosis. The procedure specific morbidity was 3.8%. No post-operative complication was related to P-Rme. At 64 months median follow-up, survival outcomes in the study group were similar to patients in the control group.
CONCLUSIONS: Overall, almost 20% of the VPD patients needed P-Rme to obtain a CR. P-Rme was a safe and effective step during VPD. The rate of CR in the study group was 100% achieved thanks to the addition of the P-Rme. No procedure specific post-operative complications occurred but 3.8% of the patients had unplanned additional surgery related to these procedures.
METHODS: In April 2009 we registered a protocol study on the safety and feasibility of P-Rme. In the period April 2009-December 2022, 687 patients with FIGO stage IIIC-IV ovarian cancer underwent VPD. One hundred and twenty-nine patients (18.7%) had extensive disease on the mesentery and underwent P-Rme. Feasibility was assessed as the number of procedures completed. Efficacy was measured as the rate of Complete Resection (CR). Safety was defined by the intra- and post-operative morbidity rate specifically associated with these procedures.
RESULTS: In all patients P-Rme was successfully completed. P-me was performed in 82 patients and R-me in 47, both procedures in 23 patients. CR was achieved in all 129 patients with an efficacy of 100%. Intra-operatively 5 patients out of 129 experienced small bowel loop surgical devascularization. They required small bowel resection and anastomosis. The procedure specific morbidity was 3.8%. No post-operative complication was related to P-Rme. At 64 months median follow-up, survival outcomes in the study group were similar to patients in the control group.
CONCLUSIONS: Overall, almost 20% of the VPD patients needed P-Rme to obtain a CR. P-Rme was a safe and effective step during VPD. The rate of CR in the study group was 100% achieved thanks to the addition of the P-Rme. No procedure specific post-operative complications occurred but 3.8% of the patients had unplanned additional surgery related to these procedures.
摘要：
目的：描述手术技术，评估可行性，功效,在IIIC-IV期卵巢癌（OC）患者中，内脏-腹膜膨化（VPD）期间进行腹壁切除术和/或肠系膜切除术（P-Rme）的安全性。
方法：2009年4月，我们注册了一项关于P-Rme安全性和可行性的方案研究。在2009年4月至2022年12月期间，687例FIGOIIIC-IV期卵巢癌患者接受了VPD。一百二十九名患者（18.7％）患有肠系膜广泛疾病并接受P-Rme治疗。可行性评估为已完成的程序数量。功效测量为完全切除(CR)的速率。安全性由与这些手术具体相关的术中和术后发病率来定义。
结果：所有患者均顺利完成P-Rme。在82例患者中进行了P-me，在47例患者中进行了R-me，均在23例患者中进行了手术。所有129例患者均达到CR，疗效为100％。手术中，129例患者中有5例经历了小肠环手术断流术。他们需要小肠切除和吻合。手术特异性发病率为3.8%。术后无并发症与P-Rme相关。在64个月的中位随访时间，研究组的生存结局与对照组患者相似.
结论：总体而言，近20%的VPD患者需要P-Rme才能获得CR.P-Rme是VPD过程中安全有效的步骤。由于添加了P-Rme，研究组的CR率为100％。没有特定的手术后并发症发生，但3.8％的患者进行了与这些手术相关的计划外额外手术。
方法：2009年4月，我们注册了一项关于P-Rme安全性和可行性的方案研究。在2009年4月至2022年12月期间，687例FIGOIIIC-IV期卵巢癌患者接受了VPD。一百二十九名患者（18.7％）患有肠系膜广泛疾病并接受P-Rme治疗。可行性评估为已完成的程序数量。功效测量为完全切除(CR)的速率。安全性由与这些手术具体相关的术中和术后发病率来定义。
结果：所有患者均顺利完成P-Rme。在82例患者中进行了P-me，在47例患者中进行了R-me，均在23例患者中进行了手术。所有129例患者均达到CR，疗效为100％。手术中，129例患者中有5例经历了小肠环手术断流术。他们需要小肠切除和吻合。手术特异性发病率为3.8%。术后无并发症与P-Rme相关。在64个月的中位随访时间，研究组的生存结局与对照组患者相似.
结论：总体而言，近20%的VPD患者需要P-Rme才能获得CR.P-Rme是VPD过程中安全有效的步骤。由于添加了P-Rme，研究组的CR率为100％。没有特定的手术后并发症发生，但3.8％的患者进行了与这些手术相关的计划外额外手术。
