腹腔镜手术治疗儿童及青少年附件扭转21例

Laparoscopic Surgery for Adnexal Torsion in Children and Adolescents:a Report of 21 Cases

目的探讨儿童及青少年附件扭转腹腔镜手术中保留卵巢的可行性。方法回顾性分析2018年1月~2022年1月21例儿童及青少年术前考虑附件扭转患者行腹腔镜手术的临床资料。年龄8~17岁,(11.7±2.6)岁。结果腹腔镜手术均顺利完成。20例保留卵巢,1例因卵巢坏死行单侧附件切除术。手术时间(73.0±8.4)min,住院日(4.5±1.1)d,无粘连性肠梗阻、切口感染、血栓性疾病等并发症发生。术后3个月复查B超,20例保留患侧卵巢者卵巢血流正常,双侧卵巢体积差异无统计学意义(P>0.05)。随访5~53个月,中位随访时间12个月。1例术后15个月卵巢囊肿复发,切除附件,病理为卵巢交界性黏液性囊腺瘤。结论对于儿童及青少年附件肿物扭转,可行腹腔镜下扭转附件复位后剥除肿物,保留患侧卵巢。

Objective To explore the feasibility of preserving ovaries in laparoscopic surgery for adnexal torsion in children and adolescents.Methods From January 2018 to January 2022,clinical data of 21 children and adolescents who underwent laparoscopic surgery for preoperative consideration of adnexal torsion were retrospectively analyzed.The age was 8-17 years old[mean,(11.7±2.6)years old].Results All the laparoscopic operations were completed successfully.The ovaries were preserved in 20 cases,and 1 case underwent adnexectomy due to ovarian necrosis.The mean operation time was(73.0±8.4)min,and the hospital stay was(4.5±1.1)d.There were no complications such as adhesive intestinal obstruction,incision infection,or thrombotic disease.The B-ultrasonography was re-examined at 3 months after the operation,and the ovarian blood flow in the 20 patients who preserved the ovarian was restored,without significant difference between bilateral ovarian volume(P>0.05).Follow-ups for 5-53 months(median,12 months)showed 1 case of recurrence at 15 months after operation,who was given salpingo-oophorectomy with a pathological result of borderline mucinous cystadenoma of the ovary.Conclusion For adnexal torsion in children and adolescents,laparoscopic detorsion of adnexal masses and cystectomy can be used to preserve the affected ovary.