腹腔镜行卵巢囊性畸胎瘤切除术术式探讨

The operating approaches of laparoscopic resection for ovarian benign cystic teratomas

目的 探讨电视腹腔镜下卵巢囊性畸胎瘤治疗的手术方式。 方法 6 7例卵巢囊性畸胎瘤行腹腔镜手术 ,其中囊肿直径 >8cm者 2 7例 ,2 3例行卵巢囊肿切除术或附件切除术 ,4 4例行囊肿剥除术。术中使用标本袋并以大量的温盐水冲洗腹腔 ,对较大的囊肿均行穿刺抽液 ,囊肿缩小后经腹壁戳口取出。 结果 卵巢囊肿剥除术中有 17例 (17/ 4 4 )囊肿破裂 ,卵巢囊肿切除或附件切除中无 1例囊液大量外溢。手术时间为 (34± 19)分钟 ,无 1例术中并发症及中转开腹手术。术后无化学性腹膜炎发生。结论 电视腹腔镜下卵巢囊性畸胎瘤手术是安全、可行的 ,较大的囊肿也能经腹腔镜手术切除。

Objective To study the operating approaches of laparoscopic resection of ovarian benign cystic teratomas. Methods 67 patients underwent operative laparoscopy for ovarian cystic teratomas(23 ovarian cystectomies,44 oophorectomies or adnexectomies),including 27 patients who had cysts more than 8cm in diameter.In operation, a plastic bag was used and the abdominal cavity was abundantly flushed with warm physiologic saline.The larger cysts were aspirated to reduce the cysts and extracted through abdominal wall incision. Results Cyst rupture occurred in 17 cases (17/44) when cystectomy was performed. No cyst spillage occurred in all the oophorectomies and adexectomies.The mean operating time was (34±19)min.Blood loss was 3ml～7ml.No complications occurred and none of the patients needed conversion from laparoscopy to laparotomy.chemical peritonitis wes not seen in any of the patiants. Conclusions Laparoscopic surgery is safe and feasible for ovarian benign cystic teratomas and allows the removal of larger ovarian cysts.