卵巢粘液性囊腺瘤患者不同手术治疗预后的对比研究

A comparative study of the prognoses of patients with ovarian mucuous cystadenomas after different patterns of surgical therapy

目的 :对比卵巢粘液性囊腺瘤 (囊瘤 )患者不同手术方法治疗的预后。方法 :回顾分析 81例卵巢粘液性囊腺瘤患者手术治疗后的随访情况 ,分析比较囊瘤切除和子宫附件切除术后及采用腹腔镜手术和剖腹手术后的复发率 ,也比较两种切除术中肿瘤破裂与否的癌变率和复发率。结果 :81例患者平均 4 2岁 (16～ 6 7岁 ) ,均随诊 2年以上 ,平均随诊时间 4 9个月 (2 4～ 12 0个月 )。癌变率为 1.2 % ,复发率为 8.6 %。囊瘤切除术 37例中 ,腹腔镜手术和剖腹手术途径的复发率分别为 16 .7%和 12 .5 % ,差异无显著性 ;切除术中肿瘤破裂与否的复发率分别为 16 .7%和 14 .3% ,差异亦无显著性 (P >0 .0 5 )。结论 :卵巢粘液性囊腺瘤切除术后的复发率显著高于子宫附件切除术。

Objective:To investigate the prognoses of patients with ovarian mucous cystadenomas after different patterns of surgical therapy.Methods:81 cases with ovarian mucuous cystadenoma retrospectively investigated and the recurrence and malignant change among these cases were analysed.The surgical therapy,such as cystectomy and uterine adnexectomy as well as after the different surgical methods,such as laparoscopic operation and laparotomy were compared.Meanwhile the recurrent incidence after the cystectomy with and without the rupture of the tumor were compared too.Results:The 81 cases had a mean age of 42(16～67)years and a mean follow up time of 49(24～120)months.The carcinoma change rate was 1.2% and the recurrent rate was 8.6%.The recurrent rate of the patients with cystectomy was 16.2%,which was significantly higher than that of the patients with uterine adnexectomy 2.3%(P=0.023).Among the 37 cases who had performed cystectomy,16.7%(4/21)of the patients after laparoscopic operation relapsed and 12.5% of the cases after the laparotomy relapsed.There was no significant difference between these two surgical methods.The recurrent rates of the patients with and without rupture of the tumor during the cystectomy were 16.7% and 14.3% respectively,which had no significant difference.Conclusion:The rate of recurrence of the ovarian mucous cystadenoma after the cystectomy is significantly higher than that after the uterine adnexectomy.It has no significant influence to the recurrent rates of patients' prognoses that not only whether they have laparoscopic operation or laparotomy but also whether the tumor rupture happened or not during the cystectomy.