腹腔镜治疗附件包块1356例临床分析

Clinical Analysis of Laparoscopic Procedure in Treatment of 1356 Cases of the Adnexal Masses

目的:探讨腹腔镜诊治附件包块的有效性与安全性。方法:回顾性分析四川大学华西第二医院2004年1月至2005年12月妇科收治的1356例附件包块行腹腔镜治疗的病例。结果:手术适应证主要为异位妊娠、卵巢宫内膜囊肿及卵巢良性畸胎瘤,手术方式主要为输卵管造口取胚术、输卵管切除术、卵巢囊肿剥除术及患侧附件切除术,手术成功率98.45%,无严重并发症发生。术中发现可疑病例78例(5.8%),病理检查提示交界性及低度恶性包块共9例(0.66%),其中4例在腹腔镜下完成手术。既往有腹部手术史85例,77例在腹腔镜下完成手术。结论:腹腔镜技术在诊治妇科良性附件占位方面是安全有效的。

Objective：The aim of this study was to estimate the efficacy and safety of laparoscopy in the diagnosis and management of adnexal masses.Methods：To analyze retrospectively the clinical data of 1356 cases of the adnexal masses who underwent laparoscopic procedure during the period of 2004.1～2005.12.Results：The major indications for laparoscopic procedure were ectopic pregnancy,ovarian cyst,and ovarian innocent dysembryoma.The major operative modalities included salpingotomy,salpingectomy,excision of ovary tumors,salpingo-oophorectomy.The operative achievement ratio was 98.45%,and the serious complications were not occurred.Seventy-night doubtful cases（5.8%）were found from pathologic examinations,it revealed that 9 cases（0.66%）had borderline and low potential malignancy masses,and 4 cases of them were undertaken laparoscopy.There were 85 patients with histories of adbomen surgery,and 77 of them were undertaken laparoscopy.Conclusion：With advancement of laparoscopic techniques,the indications for laparoscopic surgery could be widened with decrease of complications and the laparoscopic procedure was effective and safe in diagnosis and management of adnexal masses.