腹腔镜手术治疗卵巢子宫内膜异位囊肿(附128例病例报告)

Ovarian endometrial cyst treated with laparoscopic surgery in 128 cases

目的:探讨腹腔镜下手术治疗卵巢子宫内膜异位囊肿的临床疗效。方法:对128例卵巢子宫内膜异位囊肿患者施行腹腔镜下囊肿剥除术加盆腔粘连松解术,以同期96例行传统开腹剥除卵巢子宫内膜异位囊肿的患者为对照组,对两组的临床资料和术中术后情况及随访结果进行分析。结果:两组手术均无严重并发症发生,腹腔镜组无一例中转开腹,且手术时间、术中出血量、术后疼痛、术后排气时间、留置导尿时间和术后住院时间明显少于对照组(P<0.05);两组术后症状缓解率无差异,腹腔镜组子宫内膜异位囊肿复发率明显低于对照组(P<0.05);对两组合并不孕的患者术后随访4～36个月,腹腔镜组术后妊娠率为46.3%,明显高于对照组的23.7%。结论:腹腔镜手术是治疗卵巢子宫内膜异位囊肿的一种安全可靠的首选术式。

Objective： To explore the clinical efficacy of laparoscopic surgery in treatment of ovarian endometrial cyst. Methods： 128 cases with ovarian endometrial cyst underwent cysteetomy under laparoseopy and lysis of pelvic adhesions, at the corresponding period, 96 cases with ovarian endometrial cyst underwent cystectomy of laparotomy, the clinical data, intraoperative and postoperative situations, resuits of follow - up in the two groups were analyzed. Results ： No severe complication occurred, no case turned to open surgery in laparoscopy group, the operative time, intraoperative blood loss, postoperative pain time and anus exhausting time, indwelling catheter time and postoperative hospital stay in laparoscopy group were shorter than those in control group （ P 〈 0. 05 ） . There was no significant difference in remission rate of postoperative symptoms between the two groups, the recurrence rate in laparoscopy group was lower than that in control group （P 〈 0.05） . The patients with infertility in the two groups were followed up for 4 - 36 months, the pregnancy rate in laparoscopy group was 46. 3% , which was significantly higher than that in control group （23.7%） . Conclusion： Laparoscopic surgery is a safe and reliable method in treatment of ovarian endometrial cyst.