腹腔镜手术在儿童卵巢肿瘤治疗中的应用

Clinical value of laparoscopic surgery for ovarian tumors in children

目的探讨腹腔镜手术在儿童卵巢肿瘤治疗中的效果及注意事项。方法回顾性分析2006年7月-2013年12月该院运用腹腔镜手术治疗的38例儿童卵巢肿瘤的临床资料。结果所有病例均在腹腔镜下完成,无1例中转开腹,无术中并发症发生。行卵巢肿瘤剥除术35例,其中5例为卵巢囊肿蒂扭转,经复位后卵巢血供良好。3例早期生殖细胞肿瘤最终行患侧卵巢输卵管切除。手术平均时间（35±15）min,术后12～24 h肛门恢复排气,术后恢复良好,平均住院时间（4±1）d。33例随访8个月～7年,患儿无生长发育异常。3例生殖细胞肿瘤患儿随访24～51个月,未发现肿瘤复发征象。结论腹腔镜手术治疗儿童卵巢肿瘤具有损伤小、术后恢复快及并发症少等优点。术前要注意患者的选择,术中注意气腹压力的控制,注意卵巢功能的保护及遵循无瘤原则。

【Objective】To investigate the result and precautions of laparoscopic surgery for ovarian tumors in children. 【Methods】Clinical data of our 38 children with ovarian tumors who underwent laparoscopic surgery from July 2006 to December 2013 were retrospectively analyzed. 【Results】All operations were successfully performed with laparoscopy, no case received laparotomy. Thirty-five cases underwent ovarian cystectomy with 5cases of ovarian cyst torsion and 3 cases of germ cell malignancy underwent unilateral salpingo-oophorectomy. The average surgery time was（35 ± 15） min, no surgical complications occurred, anus exhaust was recovered 12 to 24 h after surgery, all cases recovered, postoperative hospital stay was（4 ± 1） d. Children grew and developed normally, no recurrence and associated complications were found in followed up of 8 months to 7 years in 33 cases. No recurrence were found in the follow-up of 24 months to 51 months in 3 cases of germ cell malignancy. 【Conclusion】Laparoscopic surgery for ovarian tumors in children is a satisfactory procedure with the advantages of minimal invasion,faster recovery and fewer complication, it is safe and effective. We should pay attention to the selection of patients before surgery, and intraoperative pneumoperitoneum pressure control, protection of ovarian function and the principle of tumor-free technique.