腹腔镜手术治疗小儿卵巢肿瘤26例

Laparoscopic operations for ovarian tumors: Experience of 26 children

目的 探讨腹腔镜手术治疗小儿卵巢肿瘤的效果及安全性. 方法 2000年1月～2005年3月,我们对26例小儿卵巢肿瘤行腹腔镜手术.气管插管全麻或静脉复合麻醉,行卵巢肿瘤剥除术或一侧附件切除术.对直径〈5 cm的肿瘤,在肿瘤的外侧缘线形电凝囊肿包膜;直径〉5 cm的肿瘤,在其中部或距基底部3 cm处环形电凝囊肿包膜,钝性分离肿瘤与囊壁,完整剥出肿瘤,残余囊壁创面彻底电凝止血,不缝合.卵巢冠囊肿切除.影响术野的大卵巢囊肿,先穿刺吸净囊液,帽状电凝卵巢囊肿包膜一周,再剥出肿瘤. 结果 所有患儿卵巢肿瘤手术都在腹腔镜下完成,肿瘤剥除术24例,一侧附件切除2例.手术时间（50±20） min,术中出血量（30±10） ml,术后住院2～4 d,无手术并发症,无伤口感染.24例随访1年,未见复发. 结论 腹腔镜手术治疗小儿卵巢肿瘤是一种安全、有效的手术方法.

Objective To investigate the efficacy and safety of laparoscopic operations of ovarian tumors in children. Methods A total of 24 children with ovarian tumors treated laparoscopically from January 2000 to March 2005 were studied. The laparoscopic operations （tumor enucleation or unilateral adnexectomy） were conducted under general anesthesia with endotracheal intubation. Electrocoagulation of the capsule was performed alongside the borderline of the lesion for tumors 〈 5 cm in diameter, or was performed circlewise in the central part or at the site 3 cm apart from the basal part of the lesion for tumors 〉 5 cm in diameter. After blunt dissection of the tumor and capsule, the lesion was completely enucleated. Hemostasis of the residual cut surface was accomplished by using electrocoagulation, with no need of suture. For large ovarian cysts disturbing laparoscopic visualization, the aspiration of hydatid fluid was conducted before the enucleation. Results All the operations were successful completed under laparoscope, including 24 cases of tumor enucleation and 2 cases of unilateral adnexectomy. The operation time was 50 ± 20 rain, the amount of hemorrhage was 30±10 ml, and the postoperative hospital stay was 2 - 4 d. No surgical complications or wound infection occurred. Follow-up in the 24 cases for 1 year found no recurrence. Conclusions Laparoscopic operations for ovarian tumor in children is safe and effective.