卵巢良性肿瘤经阴道手术术式探讨

Investigation of tumor of the ovary using a transvaginal approach

目的:探讨卵巢良性肿瘤经阴道手术的可行性和安全性。方法:回顾性分析74例经阴道手术的卵巢良性肿瘤患者的临床资料,患者的一般情况、手术方式、方法、术中及术后情况。结果:年龄22-69岁,平均年龄40岁,阴道分娩史占70.27%(52/74),剖宫产史占8.11%(6/74),其中2例有2次剖宫产史。无产史占21.62%(16/74),其中流产史4例,无孕史占16.22%(12/74),有妇科盆腔手术史占8.11%(6/74)。74例患者无中转开腹。手术时间20-65分钟,平均30分钟。术中出血20-60毫升,平均30毫升。术后排气时间6-24小时,平均10小时。术后无发热,住院天数2-6日,阴道伤口愈合良好。术后病理诊断:畸胎瘤占40.54%(30/74),子宫内膜异位囊肿占25.68%(19/74),黄体囊肿及滤泡囊肿等生理性囊肿占12.16%(9/74),浆液性囊腺瘤占10.81%(8/74),黏液性囊腺瘤占6.76%(5/74),卵巢纤维瘤及泡膜纤维瘤占4.05%(3/74)。结论:术者应具有娴熟的手术技巧和丰富经验,严格把握适应证,卵巢良性肿瘤经阴道手术是安全可行的。

Objective：To evaluate the feasibility and safety of transvaginal removal of tumor of the ovary. Methods：To performe a retrospective analysis of 74 cases of tumor of the ovary using a transvaginal approach including their clinical data, general condition, surgical approach and method, intraoperative condition and postoperative condition. Results： The mean age was 40 years old （ 22 - 69 years old ） . The cases with vaginal delivery accounted for 70.27% （52/74）. The eases with cesarean section accounted for 8.11% （6/74） with 2 patients having 2 cesarean sections;no production accounted for 21.62% （16/74） involving four abortion eases and no pregnancy accounted for 16.22% （12/74）. Gynecological pelvic surgery accounted for 8. 11% （6/74）. 74 patients with no conversion to open, surgery time ：20 - 65 minutes （ average 30 minutes）, blood loss was 20 - 60ml （ average 30ml）, the postoperative exhaust time ：6 -24 hours（ average 10 hours）, no postoperative fever, hospital days 2 -6, vaginal wound healed well. Pathological diagnosis： teratoma accounted for 40. 54% （30/74）, endometriosis 25.68% （19/74）, corpus lnteum cysts and follicular cysts and other physiological cysts 12.16% （ 9/74 ） , serous cystadenoma 10.81% （8/74） , mucinous cystadenoma 6. 76% （5/74） , ovarian fibroma and theca fibroma 4.05 % （3/74） . Conclusion：As long as the surgeon has a skilled vaginal surgical skills and extensive surgical experience tumor of the ovary vaginal surgery is safe and feasible.