腹腔镜诊治盆腔开放性手术史附件包块患者的临床分析

Clinical analysis of laparoscopic diagnosis and treatment of adnexal masses patients with open pelvic operation history

目的:探讨为有盆腔开放性手术史的附件包块患者行腹腔镜手术的安全性和可行性。方法:2005年1月至2009年12月腹腔镜手术诊治附件包块患者共765例,随机抽取有盆腔开腹手术史112例作为研究组,无盆腔手术史的125例为对照组,对比分析两组患者手术情况。结果:两组在手术成功率、术中出血量、术后胃肠功能恢复时间、住院时间等方面差异无统计学意义(P>0.05)。手术时间观察组长于对照组(P<0.05)。两组均无并发症发生。盆腔粘连率观察组80.35%,对照组28.80%,差异有统计学意义(P<0.01)。结论:有盆腔开放性手术史的附件包块患者需再次手术时,选择腹腔镜手术安全可行,可避免再次开腹手术导致的创伤和粘连,但应掌握手术技巧,严防并发症的发生。

Objective：To study the safety and feasibility of laparoscopic operation for patients with adnexal masses and pelvic open surgery history.Methods：From Jan.2005 to Dec.2009,765 patients suffered from adnexal masses underwent laparoscopic diagnosis and treatment.From them,112 cases with pelvic laparotomy history were randomly selected as study group,while 125 cases without history of pelvic surgery were chosen as control group,in order to compare the two surgical procedures.Results：The success rate of laparoscopic surgery,blood loss,postoperative recovery time of gastrointestinal function,hospital stay were not significantly different between the two groups（P0.05）.Operative time of observation group was longer than the control group（P0.05）.There were no complications.Pelvic adhesion rate were 80.35% in observation group and 28.80% in control group,the difference was statistically significant（P0.01）.Conclusions：Laparoscopic surgery is safe and feasible for patients with adnexal mass and history of pelvic open surgery,this procedure can avoid trauma and adhesion caused by re-laparotomy.But the surgical technique should be mastered to prevent complications.