Tab. 8Caratteristiche delle pazienti
Valutazione dei fattori di rischio
Esame obiettivo: visita ginecologica
Valutazione di sintomatologia
sospetta Isteroscopia e citologia endometriale Ecografia trans vaginale
Numero pazienti 81 Tipo di tumore Ovaio Utero 75 6 Stadio FIGO Ovaio Ic 3 IIb 1 IIIb 6 IIIc 48 IV 17
Tab. 9Procedure chirurgiche effettuate
Resezioni intestinali
Resezioni retto- sigma Emicolectomia dx Hudson-Dalle Piane Resezione del tenue Resezioni del sigma Resezioni del trasverso
Resezione cieco ed ultima ansa tenue
Numero pazienti 29 11 11 5 3 2 2 Nefrectomie 1
Resezioni vescicali ed altri interventi su ureteri 7 posizionamenti di stent urete- rali
4 resezioni parziali della vesci- ca Splenectomia 1 Gastroresezioni 2 Stomie Colostomia Gastrostomia Ileostomia Digiunostomia Cecostomia 21 16 8 3 1
Tab. 10 Complicazioni perioperatorie
Complicanze Numero pazienti
Complicanze intestinali
Deiscenze anastomotiche
2
Complicanze maggiori
Morte entro 30 giorni Embolia polmonare Insufficienza renale acuta
7 1 2
Altre complicanze
Lesioni intraoperatorie Infezione della ferita
5 1
Giorni di degenza (range 9-56) 18
Tab. 11 Risultati delle complicanze in procedure di debulking effettuate durante chi- rurgia citoriduttiva primaria e secondaria per neoplasia ovarica
Morbilità Studi Pazien- ti Ottimale (%) Chirur- gia Sopravviven- za Intestino correlate Mortalità (%) RESEZ INTESTINA- LE Gillette-Clove(2001) Mourton (2005) Hoffman (2005) Aletti (2006) Estes (2006) Tebes (2006) 105 70 144 57 48 125 33 NR 100 NR 52 75 primaria primaria primaria primaria primaria entrambe 59 60 19 12 27 37 27 5.7 2.8 3,4 2 30,5 5,7 1,4 0 0 4 2,4 RES.ADDOMINALI Cliby (2004) Aletti (2006) Eisenhauer (2006) 41 194 57 NR 67,5 100 entrambe primaria primaria 19,5 NR 12 0 1,5 NR SPLENECTOMIA Magtibay (2006) Manci (2006) 112 24 NR 100 entrambe second. 5 0
Nota: La mortalità è per qualsiasi causa entro 30 giorni dall’intervento. La morbilità correlata all’intestino inclu-
de:canalizzazione dopo 10 giorni, perforazioni del viscere, deiscenze anastomotiche, e complicanze intraoperato- rie durante la chirurgia;
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