腹腔镜与开腹手术治疗卵巢子宫内膜异位囊肿的疗效比较

Laparoscopy versus laparotomy for the treatment of ovarian endometriosis cysts

目的比较腹腔镜手术与开腹手术治疗卵巢子宫内膜异位囊肿的效果,探讨腹腔镜手术治疗卵巢子宫内膜异位囊肿的价值.方法回顾性对比分析随访4个月～5年,平均41.3月的92例腹腔镜手术(腹腔镜组)及52例开腹手术(开腹组)的临床资料.结果腹腔镜组手术时间(69±41.8)min,术后住院(3.5±1.0)d,术中出血量(55±12.0)ml;开腹组手术时间(137±54.3)min,术后住院时间(8.7±3.5)d,术中出血量(178±105.9)ml,两组比较差异均有显著性(t=-8.402,-11.048,-13.350;P=0.000).术后复发率腹腔镜组19.6%(18/92),开腹组19.2%(10/52),两组差异无显著性(x2=0.002,P=0.961).术后痛经改善率腹腔镜组66.0%(35/53),开腹组52.8%(19/36),两组比较差异无显著性(x2=1.580,P=0.209).结论腹腔镜治疗卵巢子宫内膜异位囊肿的效果与开腹手术基本相同,但腹腔镜具有微创手术的优点,可作为治疗卵巢子宫内膜异位囊肿的首选方法.

Objective To compare effects between laparoscopy and laparotomy for the treament of ovarian endometriosis cysts and to investigate the value of laparoscopy in the treatment of ovarian endometriosis cysts. Methods We retrospectively analyzed 144 cases of ovarian endometriosis cysts, 92 of which underwent laparoscopic operations （Laparoscopic Group） and 52 of which received open operations （Open Group）. All the cases were followed for 4 months - 5 years. Results The operation time, postoperative hospital stay, and intraoperative blood loss were 69 ±41.8 min, 3.5 ±1.0 d, and 55 ± 12.0 ml in the Laparoscopic Group, respectively, and 137 ±54.3 min, 8.7 ±3.5 d, and 178 ± 105.9 ml in the Open Group, respectively, with significant differences between the two groups （ t = - 8. 402, - 11. 048, and - 13. 350 ;P = 0. 000）. There was no significant difference in the rate of abdominal pain relief between the Laparoscopic Group （66.0%, 35/53 ） and the Open Group （52.8%, 19/36） （χ^2 = 1. 580, P =0. 209）. The recurrent rate was 19.6% （18/92） in the Laparoscopic Group and 19.2% （10/52） in the Open Group, without significant difference between the two groups （χ^2 = 0.002, P = 0.961 ）. Conclusions Laparoseopie surgery gives similar efficacy to open surgery in the treatment of ovarian endometriosis cysts. Laparoscopic surgery can be used as the first choice in treating ovarian endometriosis cysts because of its minimally invasive characteristics.