腹腔镜剔除卵巢畸胎瘤可行性分析

A feasibility study on laparoscopic removal for ovarian mature teratoma

目的探讨应用腹腔镜进行卵巢成熟畸胎瘤剔除的可行性。方法回顾性分析47例卵巢畸胎瘤行腹腔镜下肿瘤剔除术,同期27例采用传统的开腹手术行肿瘤剔除术,对两组病人的术中囊肿破裂率、手术时间、术中出血、手术前后血红蛋白、术后病率及住院时间进行比较分析。结果两组术中囊肿破裂率相近(12.8%vs11.1%,P>0.05);两组手术时间相近[(83±22)minvs(80±16)min,P>0.05]。腹腔镜组手术前后血红蛋白无明显改变[(114.4±3.5)g/Lvs(113.1±2.9)g/L,P>0.05];开腹组手术后血红蛋白下降[(113.8±2.7)g/Lvs(110.9±1.1)g/L,P<0.05]。腹腔镜组术中出血少[(53±25)mlvs(75±16)ml,P<0.001];肛门排气时间早,两组肛门排气时间分别为(19.0±2.1)h和(27.0±1.8)h(P<0.001);术后病率低,两组术后病率分别为2.1%(1/47)和22.2%(6/27)(P<0.05);术后住院时间短,两组术后住院时间分别为(4.4±0.7)d和(7.0±0.2)d(P<0.001)。结论全部病人随访1-4年,两组均无复发。应用腹腔镜剔除卵巢成熟性畸胎瘤是可行且优于传统开腹手术。

Objective To investigate the feasibility of laparoscopic removal for ovarian mature teratoma. Methods Forty-seven patients with ovarian mature teratoma underwent laparoscopic removal（ laparoscopy group）, while 27 patients underwent laparotomy（ laparotomy group）. The cyst rupture, the changes of hemoglobin before and after operation, the operation time, the averaged volume of blood loss, postoperative morbidity, the anus exhaust time and the hospitalized days were compared between two groups. Results The cyst rupture and the operation time showed no significant difference between laparoscopy group and laparotomy group[ 12.8% vs 11.1%, （83 ±22）min vs （80 ±16）min, P 〉 0.05 ]. The hemoglobin showed no significant change before and after operation in laparoscopy group[ （ 114.4 ± 3.5 ） g/L vs （ 113. 1 ± 2.9 ） g/L, P 〉 0.05 ], while the level of hemoglobin significantly decreased after operation [ （ 113.8 ± 2.7） g/L vs （ 110.9 ± 1.1 ） g/L, P 〈 0.05 ]. The averaged volume of blood loss, anus exhaust time and hospitalized days were statistically lower in laparoscopy group than in laparotomy group （ P 〈 0.05 ）. Postoperative morbidity in laparoscopy group and laparotomy group were 2. 1% and 22.2% ,respeetively（P 〈 0.05）. All patients were followed up for 1 -4 years. None relapsed in 2 groups. Conclusion Laparoscopic removal for ovarian mature teratoma is a feasible procedure, and it is superior to laparotomy.