腹腔镜巨大卵巢囊肿剥除术中残留卵巢的处理方法

Management of residual ovarian parenchyma in laparoscopic giant ovarian cystectomy

目的研究腹腔镜巨大卵巢囊肿剥除术中处理残留卵巢的可行性方法。方法 2004年1月～2010年3月对28例巨大卵巢囊肿患者采用腹腔镜卵巢囊肿剥除术,先刺破囊肿、吸净囊液,再剥除囊壁、及时电凝创面,最后行残留卵巢连续聚合缝合+订书式缝合,选择28例同期行腹腔镜巨大卵巢囊肿剥除术常规间断缝合残留卵巢的患者做为对照组。结果全部患者均顺利完成手术,术中未发生任何并发症,实验组的平均手术时间(76.3±9.0)min,术中平均出血量(35.2±8.9)mL,均少于对照组(P<0.05)。结论腹腔镜下手术治疗巨大卵巢囊肿安全可行,运用该研究中处理残留卵巢的方法可以简化手术操作,缩短手术时间,减少术中出血,有较大的应用价值,可在临床推广使用。

[Objective] To investigate the feasible method of managing residual ovarian parenchyma in laparoscopic giant ovarian cystectomy.[Methods] From January 2004 to March 2010 data related to 28 patients with giant ovarian cysts who underwent laparoscopic ovarian cystectomy were reviewed using the method that is firstly piercing the cyst and sucking the cyst fluid,secondly stripping the cyst wall and bipolar electrocoagulation the cyst bed immediately,finally consecutively suturing the edges of residual ovarian parenchyma to be connivent and suturing the cyst bed like bookbinding.28 patients who underwent laparoscopic giant ovarian cystectomy with interrupted suturing of residual ovarian parenchyma were used as control group.[Results] All the surgeries were accomplished successfully under laparoscopy.No complication happened in all patients.The mean operation time was（76.3±9.0） min and the mean intraoperative blood loss was（35.2±8.9） mL in experimental group,lower than control group（P〈0.05）.[Conclusions] Laparoscopic giant ovarian cystectomy is safe and feasible.This method that can simplify the operation,decrease the operation time and reduce the intraoperative blood loss is worth applying and generalizing in clinic.