腹腔镜手术治疗卵巢良性病变的价值——附1387例分析

The value of laparoscopic management for benign ovarian diease:A report ot 1387 cases.

目的 探讨腹腔镜手术治疗卵巢良性病变的临床应用价值。 方法 回顾性分析 1995年 1月至 2 0 0 1年 2月卵巢肿瘤 13 87例 ,术前根据患者的年龄、病史、B超和血清CA1 2 5水平排除恶性肿瘤确定为卵巢良性病变者施行腹腔镜手术 ,分析其疗效。 结果 术后诊断卵巢内膜异位囊肿 5 3 1例、卵巢畸胎瘤 2 5 4例、炎性肿块 13 9例、卵巢浆液性囊腺瘤 12 1例、卵巢粘液性囊腺瘤 67例、输卵管系膜囊肿 12 8例、卵巢单纯性囊肿 14 0例、卵巢纤维上皮瘤 3例、粘液性交界性囊腺瘤 1例、粘液性囊腺癌 1例、卵巢子宫内膜样癌 1例、卵巢恶性纤维上皮瘤 1例。术前、术后卵巢良性病变诊断符合率 99 7%。 13 87例除 2例卵巢癌 ,(卵巢子宫内膜样癌及卵巢恶性纤维上皮瘤各 1例 )转开腹切除子宫外 ,其余均在腹腔镜下完成手术。 结论 腹腔镜手术治疗卵巢良性病变具有同开腹手术相同的疗效 ,而且对腹腔干扰小、术后盆腔粘连减少、恢复快、并发症少、住院日短及腹部疤痕小等优点 。

Objective To evaluate the clinical value of laparoscopic procedure for benign ovarian diease. Methods 1387 cases of benign ovarian diease diagnosed from Jannary,1995 to February,2001 according to patient's age,history,ultrasound exam and tumor markers and laparoscopy were retrospectively analyzed in this study. Results 531 cases postoperatively diagnosed as endometriotic cyst,254 cases teratoma,139 inflammatory masses,121 serous cystademona,67 cases mucinous cystadenoma,128 parovarian,140 simple ovarian cyst,3 cases brenner tumor,1 case borderline mucinous cystadenoma,1 case mucinous cystadenocarcinoma,1 case endometrioid carcinoma and 1 case malignant brenner tumor.99.7% of preoperative diagnosis of benign ovarian diease was consistant with that done postoperatively laparoscopy were performed in All of the patients except for two cases of ovarian carcinoma,who were given laparohysterectomy. Conclusions Laparoscopic management for benign ovarian diease has much the same effect that laparotomy does.It should be encouraged to be clinically applied for it's quicker recovery,shorter hospitalization duration,less morbidity,and so on.