保留卵巢手术治疗儿童卵巢囊肿蒂扭转16例报告

Detorsion and cyst resection with the preservation of ovary for ovarian cyst torsion in children： a report of 16 patients

目的探讨保留卵巢手术治疗儿童卵巢囊肿蒂扭转的经验。方法回顾性分析2011年1月至2012年3月收治的儿童卵巢囊肿蒂扭转16例的临床资料。本组均行急诊开腹探查，行扭转囊肿手法复位，观察10min，血运完全恢复、颜色改善明显或复位后10min内组织缺血能有部分改善者，选择保留卵巢手术。结果本组16例均成功实施保留卵巢的囊肿切除术。复位后10min内，10例血运完全恢复；4例血运明显改善；2例复位前为黑紫色，复位后转变为浅紫色，均行保留卵巢的囊肿切除术。术后恢复顺利，无一例肺栓塞并发症发生。16例患儿术后随访3～17个月，卵巢血运恢复好。结论儿童卵巢囊肿蒂扭转的早期诊断和及时手术非常关键，对于良性囊肿，应根据卵巢肿瘤扭转蒂复位后血运情况尽量保留患侧卵巢。

Objective To present our experience of detorsion and cyst resection with the preser- vation of ovary for ovarian cyst torsion in children. Methods Between January 2011 and March 2012, 16 patients with ovarian cyst torsion underwent emergency surgery at our center. Their clinical data was retrospectively analyzed. The partially or completely restoration of the ovarian blood supply was seen in 10 minutes after detorsion procedure, and then followed by cyst resection. Results All operations was done successfully. Within 10 minutes after detorsion, ovarian blood supply restored completely in 10 patients, partly restored in 4 patients, and poor blood restoration was found in 2 cases. The cystectomy with preservation of ovary was conducted in all patients. No complications occurred during and after operation. All patients were followed up for 3 to 17 months, and all presented good ovarian blood supply. Conclusions Early diagnosis and immediate management are of great significance for preserving ovarian function in children and reducing postoperative complications. Detorsion and cyst resection with the preservation of ovary is feasible for ovarian cyst torsion in children.