腹腔镜与开腹手术治疗卵巢畸胎瘤的比较

Comparison of surgical treatment of ovarian teratoma by either laparoscopy or laparotomy

目的与开腹手术比较,探讨腹腔镜手术治疗卵巢畸胎瘤的疗效及安全性。方法回顾性分析该院妇科1998年1月～2002年12月收治的297例卵巢畸胎瘤的手术治疗及疗效。结果平均手术时间腹腔镜组(82.9±23.7)min长于开腹组(67.3±18.3)min(P<0.01);术中出血腹腔镜组(38.4±25.1)mL少于开腹组(81.1±31.3)mL(P<0.01)。两组肿物大小与手术时间均呈正相关。腹腔镜组术后体温低、肛门排气快。住院天数腹腔镜组(9.7±2.6)d短于开腹组(12.1±2.8)d(P<0.01);住院费用腹腔镜组(6624.8±628.0)元高于开腹组(5453.8±953.0)元(P<0.01)。腹腔镜组术后恢复较开腹组快。两组术后并发症及畸胎瘤复发率均相似。结论腹腔镜手术治疗卵巢良性畸胎瘤的疗效和开腹手术相似,虽然住院费用稍高但具有损伤小、出血少、住院时间短、恢复快等优点。

[Objective]To compare the effectiveness and safety of surgical treatment of ovarian teratoma by either laparoscopy or laparotomy. A total of 297 conservative cases of ovarian teratoma treated by either laparoscopy or laparotomy in our hospital from Jan. 1998 to Dec.2002 were reviewed retrospectively. The mean operating time of the laparoscopy group (82.9±23.7) min was slightly longer than that of the laparotomy group(67.3±18.3) min, (P<0.01) and the operation time was positively related to size of tumors. Estimated blood loss of the laparoscopy group (38.4±25.1) mL was less than that of the laparotomy group(81.1±31.3) mL, (P <0.01). The laparoscopy group had lower postoperative temperature and quicker recovery of bowl movement. The mean days of hospitalization in the laparoscopy group (9.7±2.6) d were shorter than that in the laparotomy group (12.1±2.8) d, (P<0.01); Medical costs in the laparoscopy group (6624.8±628.0, Yuan RMB) was higher than that in the laparotomy group(5453.8±953.0), (P<0.01). Both postoperative complications and the recurrence rate of the teratoma were similar in the two groups. [Conclusions] Laparoscopic treatment of ovarian teratoma has similar effectiveness and safety to laparotomy and is of less trauma, less blood loss, shorter time of hospitalization and quicker recovery although with slight high medical costs.