腹腔镜手术治疗妊娠合并卵巢肿瘤30例报告

Clinical analysis of laparoscopic surgery for ovarian tumors during pregnancy:a report of 30 cases

目的：探讨妊娠合并卵巢肿瘤的临床特点及腹腔镜手术技巧。方法：回顾分析2003年1月至2010年7月为30例妊娠合并卵巢肿瘤患者行腹腔镜手术的临床资料。患者平均27.3岁,其中18例孕周小于12周,12～18周12例。经产妇7例。11例有腹部症状,2例阴道流血。肿瘤直径平均76.7mm。结果：30例均顺利完成腹腔镜手术,无中转开腹及并发症发生。24例行腹腔镜卵巢肿瘤剥除术,5例行腹腔镜患侧附件切除术,1例行腹腔镜患侧卵巢黄体囊肿蒂扭转复位术。手术时间85～120m in,术中出血约10m。l术后平均住院3.8d。术后病理诊断卵巢成熟型囊性畸胎瘤18例（60%）,黄体囊肿6例（20%）,卵巢甲状腺肿2例（6.7%）,粘液性囊腺瘤2例（6.7%）,浆液性囊腺瘤1例（3.3%）,交界性乳头状粘液性囊腺瘤、局灶腺体癌变1例（3.3%）。术后足月分娩20例,8例患者于术前或术后要求放弃胎儿,2例术前发生难免流产。结论：腹腔镜手术诊治妊娠合并卵巢肿瘤具有患者创伤小、出血少、术后康复快、对妊娠影响少等优点。

Objective：To investigate the clinical characteristics and laparoscopic of ovarian tumors during pregnancy.Methods：The clinical data of 30 pregnant women with ovarian tumors underwent laparoscopic surgery between Jan.2003 and Jul.2010 were analyzed retrospectively.The average age was 27.3 years old.Eighteen cases were less than 12 weeks of gestational age,12 cases were between 12 and 18 weeks.Abdominal symptom was present in 11 cases,vaginal bleeding was present in two.The average tumor size was 76.7mm.Results：Laparoscopic surgery was successfully performed on all patients,24 cases with laparoscopic excision of ovarian tumor,5 cases with laparoscopic resection of the affected side annex and one with laparoscopic ipsilateral corpus luteum cyst torsion reduction.The operation time was 85-120min,blood loss was 10ml,mean hospital stay was 3.8 days.Pathological diagnosis was ovarian mature cystic teratoma in 18 cases（60%）,luteal cyst in 6 cases（20%）,ovarian goiter in 2 cases（6.7%）,mucinous cystadenoma in 2 cases（6.7%）,serous cystadenoma in 1 case（3.3%）,borderline papillary mucinous cystadenoma,focal gland with canceration in 1 case（3.3%）.Post operation,20 cases were pregnant to term delivery,8 cases in the preoperative or postoperative period gave up baby and inevitable abortion occurred in 2 cases prior to operation.Conclusions：Laparoscopic surgery for ovarian tumors during pregnancy is a safe and feasible technique with less trauma,less influence of pregnancy and quick recovery.