卵巢小肿块的腹腔镜检查与处理

THE MANAGEMENT OF SMALL OVARIAN MASS BY OPERATIVE LAPAROSCOPY

探索小卵巢肿块的腹腔镜检查指征与处理方法。方法 :回顾性分析 4 7例直径小于或接近 5cm卵巢肿块的腹腔镜检查结果与处理要点 ,提出卵巢肿块腹腔镜探查指征。结果 :1998年 1月～ 2 0 0 1年 6月 ,发现卵巢畸胎瘤 15例 ,卵巢子宫内膜异位瘤 11例 ,输卵管积水 7例 ,卵巢黄体 4例 ,卵巢浆液性囊性瘤 3例 ,卵巢冠囊肿 3例 ,卵巢粘液性囊性瘤 1例 ,卵巢浆液性上皮癌 1例 (Ⅱa期 ) ,卵巢颗粒细胞瘤 1例 ,卵巢纤维瘤 1例。平均手术时间 81± 37min ,平均出血量 30± 5 4ml。未见术后并发症。结论 :对于混合性、低密度或持续 3个月经周期以上卵巢肿块 ,性质不明者 ,要尽早行腹腔镜探查 ,不仅是早期发现卵巢恶性肿瘤的有效手段 。

Objective:To explore indications of small-diameter ovarian mass (equivalent or less than 5 cm ) by laparoscopic diagnosis management. Methods: The exploratory results and key steps of operative laparoscopy of small diameter ovary tumors were analyzed respectively.Results:Forty-seven cases of small diameter ovarian tumors from January I998 to June 2001 were successfully removed by operative laparoscopy.There were 15 cases of ovarian teratoma, 11 cases of ovarian endometrioma, 7 cases of hydrosalpinx, 3 cases of ovarian serous cystadenoma, 3 cases of paraovarian cyst, 1case of ovarian mucinous cystadenoma, 1 case of ovary serous cystic carcinoma at stage Ⅱa,1 case of granulose cell tumor, 4 cases of functional cyst and 1 case of ovarian fibroma as well.The average operation time is 81±37min. The average bleeding during operation is 30±54ml. Two cases were reversed to laparectomy because of the ovarian malignancies. No operation complication and spillage of the tumor was occurred.Conclusion:Small ovarian tumor with mixed,low-density or existed more than 3 cycles should be explored by operative laparoscopy as early as possible. The operative laparoscopy offers a good tool not only for the early discovery of ovarian tumors but also the standard management of the disease