2种腹腔镜下卵巢成熟性囊性畸胎瘤剥除术对残留卵巢体积影响的对比研究

Influence of Two Different Approaches of Laparoscopic Cystectomy for Mature Ovary Teratoma on Residual Ovarian Volume

目的探讨2种腹腔镜下卵巢成熟性囊性畸胎瘤剥除术对残留卵巢体积的影响。方法 47例(研究组)腹腔镜辅助下经腹壁小切口(二孔法)用手直接剥除卵巢成熟性囊性畸胎瘤,51例(对照组)传统三孔法腹腔镜下应用腹腔镜手术器械行卵巢成熟性囊性畸胎瘤剥除术,3个月后B超测量2组患者卵巢体积并进行比较。结果 3个月后研究组手术侧残留卵巢体积为(10.6±4.7)cm3,未手术侧卵巢体积为(12.1±5.1)cm3,无统计学差异(t=1.483,P=0.142);对照组手术侧残留卵巢体积为(6.7±3.2)cm3,显著小于未手术侧卵巢体积(11.4±4.9)cm3(t=-5.735,P=0.000)。研究组两侧卵巢体积相比缩小(2.2±1.0)cm3,对照组两侧卵巢体积缩小(4.3±1.9)cm3,2组有显著性差异(t=6.761,P=0.000)。结论腹腔镜辅助下经腹壁小切口行卵巢成熟性囊性畸胎瘤剥除术能有效地避免正常卵巢组织的丢失。

Objective To observe the influence of two different methods of laparoscopic cystectomy for mature ovary teratoma on residual ovarian volume. Methods Cystectomy was performed with laparoscopic-assisted approach via a small abdominal incision （ two holes） in 47 patients （ study group）, and by traditional three-hole laparoscopy in 51 patients （ control group）. B-uhrasonography was carried out in 3 months after the surgery to determine the residual ovarian volume. The results were compared between the two groups. Results In the study group, no significant difference was detected in the ovarian volume between the operated and unoperatedsides [（10.6 ±4.7） cm3 vs. （12.1 ±5.1） cm3, t=1.483, P=0.142]; while in the control group, there existed significant difference between the operated and unoperated sides [（6.7 ±3.2） cm3 vs. （11.4 ±4.9） cm3, t = -5.735, P= 0. 000 ]. The mean ovarian tissue loss in the study group was （2.2 ± 1.0） cm3 , which was significantly less than that in the control [ （4.3 ± 1.9） cm3, t = 6. 761, P = 0. 000 ]. Conclusion We recommend laparoscopic-assisted cystectomy via a small abdominal section for mature ovary teratoma to avoid loss of normal ovarian tissues.