Adult-Type Granulosa Cell Tumor with Similar Clinical Findings Seen during Ovarian Cystectomy Performed at the Same Time as Laparoscopic Ovarian Drilling for Polycystic Ovarian Syndrome: An Extremely Rare Case

Polycystic ovary syndrome (PCOS) is a major cause of anovulatory infertility. Laparoscopic ovarian drilling (LOD) is a treatment for PCOS that allows the laparoscopic identification of other intra-abdominal lesions and the provision of diagnostic treatment. This study reports a case of PCOS with an ovarian mass in which LOD was aggressively used and a granulosa cell tumor (GCT) was found. A 34-year-old woman with secondary amenorrhea and irregular menstrual cycles presented to the emergency department with abdominal pain of unknown etiology. Imaging studies revealed a 6-cm left ovarian mass with an internal appearance suggestive of a hemorrhage. The patient’s secondary amenorrhea was subsequently diagnosed as PCOS, and LOD was performed to preserve her fertility. Simultaneously, a cystectomy was performed to evaluate the tumor in the left ovary;the diagnosis was adult-type GCT. Although concomitant GCT and PCOS are extremely rare, the two conditions have similar clinical manifestations. In women of reproductive age, the impact of surgery on future fertility should be considered, and the initial surgical technique should be chosen carefully.

Effects of suspension laparoscopy and pneumoperitoneum laparoscopic surgery on ovarian function, inflammatory response and stress hormone in patients with ovarian cystectomy

Objective:To investigate the effects of suspension laparoscopy and pneumoperitoneum laparoscopic surgery on inflammatory response, stress hormone and ovarian function in patients with ovarian cystectomy.Methods: Retrospective analysis of the data of laparoscopic ovarian cyst denudation in our hospital from July 2015 to August 2017, and they were were divided into the control group and the treatment group according to the surgical methods they accepted. The levels of inflammatory factors and stress hormone preoperative and postoperative 24 h, and ovarian function of the menstrual period 3rd day preoperative and postoperative 3 months of the two groups were compared.Results: There was no significant difference in the levels of TNF-α, CRP, COR, NE, E2, LH and FSH between the two groups before the operation. Postoperative 24 h, the levels of TNF-α, CRP, COR and NE in the treatment group were significantly lower than those in the control group, and the level of E2 in the treatment group was higher than that in control group, the levels of LH and FSH in the treatment group were lower than those in control group postoperative 3 months, the difference were statistically significant.Conclusion: Compared with pneumoperitoneum laparoscopic surgery, suspended laparoscopic surgery can effectively reduce the inflammatory response, reduce the level of stress hormone and improve ovarian function in patients undergoing ovarian cystectomy, which has a certain clinical value.

Effect of modified laparoscopic salpingectomy on ovarian reserve:Changes in the serum antimüllerian hormone levels

Objective:To retrospectively estimate the impact of modified laparoscopic salpingectomy on the ovarian reserve in infertile women.Methods:There were 74 infertile women undergone modified laparoscopic salpingectomy from June 2016 to January 2017,and their levels of serum antimüllerian hormone,basal follicle-stimulating hormone and estradiol were reviewed retrospectively.Results:No significant change was detected in serum antimüllerian hormone at 3 months after surgery compared to preoperative level(p=0.857).Similar changes were observed for the basal follicle-stimulating hormone(p=0.102)and estradiol(p=0.233)level.Conclusions:Our results revealed that modified laparoscopic salpingectomy might be a valuable treatment for hydrosalpinx before in vitro fertilization.

A Randomized Control Trial Comparing Direct Stripping and Bipolar Electrocoagulation for Laparoscopic Endometriotic Cystectomy-Surgical and Histopathological Aspects

The present study compared two different techniques of endometriotic cystectomy at the hilus : continuation of strip-ping and bipolar elctrocoagulation and cuttin . This was a randomized controlled study was done on 64 patients, who had laparoscopically confirmed endometriomas > 3 cm in diameter. Endometriotic cystectomy was initiated by excision of a circular rim of tissue at the original adhesion site followed by stripping and randomization was done at the ovarian hilum into 2 groups. In Group I surgery was completed by continuation of stripping and in group II surgery was completed by bipolar coagulation and cutting with scissors. Operative time and operative difficulty were evaluated at both steps by the same surgeon. Histopathology confirmation of the loss of normal ovarian tissue was recorded in the excised cyst and at the hilus separately. Data was analysed using Stata software, fisher’s exact test was employed to assess operative difficulty and Kruskal-Wallis test was used to evaluate ovarian tissue quality. The mean operating time was reported to be significantly lesser in the coagulation and cutting group. The operative difficulty was comparable in two groups. The number of primordial follicles sacrificed showed no significant difference in both groups. Complication rate in terms of hemorrhage was higher in the direct stripping group.

Effect of laparoscopic myomectomy on inflammatory reaction, immune function, stress hormones and ovarian function

Objective: To investigate the effect of laparoscopic myomectomy on inflammatory reaction, immune function, stress hormones and ovarian function. Methods: Selected a total of 82 patients with hysteromyoma accorded with the screening criteria as the objects of study, according to the random data table, the patients were divided into the control group (n=41) and the observation group (n=41);The patients in the control group received traditional laparotomy myomectomy, and the observation group patients received laparoscopic myomectomy. The inflammatory reaction, immune function, stress hormone and ovarian function levels were compared between the two groups before and after treatment (before operation and after 1 d of operation). Results: After comparison, before treatment the difference of TNF-α, CRP, CD3+, CD4+, CD8+, CD4+/CD8+, COR, NE, LH, FSH and E2 levels between the groups was not statistically significant;After treatment, the TNF-α, CRP, CD8+, COR, NE, LH and FSH levels of two groups were significantly increased, and the levels after treatment in the control group were significantly higher than the observation group, the difference was statistically significant;The levels of CD3+, CD4+, CD4+/CD8+ and E2 in the observation group were significantly higher than those in the control group, the difference was statistically significant. Conclusion: Laparoscopic myomectomy can effectively reduce the inflammatory reaction and stress reaction, and have a less influence on the immune function and ovarian function, which is more conducive to postoperative rehabilitation.

Effects of dexmedetomidine combined with dezocine on tumor factors, immune function levels and related serum factors in patients with laparoscopic surgery for ovarian cancer

Objective:To study the effects of dexmedetomidine combined with dezocine on tumor factors, immune function levels and related serum factors in patients with laparoscopic surgery for ovarian cancer.Methods: To select 120 cases of laparoscopic ovarian cancer treated and planned to undergo laparoscopic radical operation in our hospital were randomly and equally divided into control group and treatment group. The patients in control group were treated with dezocine, the treatment group were treated with dexmedetomidine combined with dezocine. To detect and compare the serum HE4, YKL-40, TSGF, NSE, S100β protein, MDA, SOD and peripheral blood CD3+, CD4+, CD8+ and calculate CD4+/CD8+ before and after operation. Results: Before the surgery, there was no significant difference in serum HE4, YKL-40, TSGF, NSE, S100β protein, MDA and SOD between the two groups(P>0.05). After surgery, there were significant differences between the two groups in serum HE4, YKL-40, TSGF, NSE, S100β protein, MDA and SOD levels and the same group before surgery (P<0.05), the improvement of each index in the treatment group was better than those in the control group, and the differences were significantly (P<0.05). Before the surgery, the differences between the two groups in peripheral blood CD3+, CD4+, CD8+ and CD4+/CD8+ had no significant difference (P>0.05), After surgery, the differences between the two groups and the same group before operation in peripheral blood CD3+, CD4+, CD8+ levels and CD4+/CD8+ were significantly (P<0.05), the improvement of each index in the treatment group was better than that in the control group, the differences were significantly (P<0.05).Conclusion:Dexmedetomidine combined with dezocine can reduce the serum HE4, YKL-40, TSGF, NSE, S100β protein levels in patients with ovarian cancer after laparoscopic operation, reduce the oxidative stress reaction, has smaller effect on cellular immune function.

Comparison of ovarian preservation versus oophorectomy on fertility outcomes in patients with endometriosis post-laparoscopic surgery:A prospective study

BACKGROUND Endometriosis is a chronic inflammatory condition affecting a significant proportion of women of reproductive age.Although laparoscopic surgery is commonly the preferred treatment,the decision to preserve or remove the ovaries remains controversial.Previous studies have yielded inconsistent results regarding the impact of ovarian preservation vs oophorectomy on fertility outcomes and disease recurrence.This prospective study aimed to address this knowledge gap by comparing the effects of these surgical approaches on spontaneous pregnancy rates,time to pregnancy,recurrence rates,and postoperative pain in patients with endometriosis.AIM To compare the reproductive outcomes and recurrence rates between ovarian preservation and oophorectomy in women undergoing laparoscopic surgery for endometriosis.METHODS This study was conducted at a tertiary care hospital between January 2019 and December 2023.A total of 312 women aged 18 to 40 years,diagnosed with endometriosis and undergoing laparoscopic surgery,were included.The patients were categorized into the ovarian preservation group(n=204)and the oophorectomy group(n=108).The primary outcome measure was the achievement of spontaneous pregnancy within 24 months post-surgery.Secondary outcomes included time to spontaneous pregnancy,recurrence rates,and postoperative pain scores.RESULTS The ovarian preservation group exhibited a significantly higher spontaneous pregnancy rate than that in the oophorectomy group(43.6%vs 28.7%,P=0.006).Moreover,the median time to spontaneous pregnancy was shorter in the ovarian preservation group(8.2 months vs 11.4 months,P=0.018).Nonetheless,endometriosis recurrence was more prevalent in the ovarian preservation group(22.1%vs 11.1%,P=0.014).The postoperative pain scores demonstrated similar improvements in both groups,with no significant differences observed.Subgroup analyses indicated that the benefit of ovarian preservation on spontaneous pregnancy rates was more evident among younger women(≤35 years)and those with advanced-stage endometriosis.CONCLUSION Ovarian preservation is associated with a high spontaneous pregnancy rate and a short time to pregnancy.However,because of the increased risk of recurrence,the decision should be based on age,fertility aspirations,and disease severity.

Transperitoneal Laparoscopic Cystoprostatectomy for Muscle Invasive Bladder Cancer: Results and Oncologic Outcomes in a Single Center in Douala Cameroon

Background and Aim: Radical cystectomy is the treatment of choice for muscle-invasive bladder cancer. Although open surgery is currently the gold standard for this procedure, it can also be done via laparoscopy. We aimed to evaluate the oncologic results and the place of laparoscopic cystectomy in the management of bladder cancer in a single urology center in Douala, Cameroon. Patients and Methods: This is a prospective, single-center study carried out from 2015 to 2019. We included 12 patients (ten men and two women) with bladder cancer who underwent total radical laparoscopic transperitoneal cystectomy with ilio-obturator lymph node dissection. Data on patients’ demographic characteristics, pre-operative and postoperative clinical parameters and workup results, and surgical outcomes were collected to determine the overall survival using a Kaplan-Meier curve. Results: We recruited ten men and two women with a median age of 61.5 [52.8 - 68.5] years. The mean tumor diameter was 3.75 ± 1.06 cm. Three (25%) patients received adjuvant chemotherapy while eight did not. The mean surgery duration was 242 ± 45.85 minutes. Blood vessels and nerves were preserved in four (33.33%) patients during surgery. Transitional cell carcinoma was found in 10 (83.33%) patients while epidermoid carcinoma was found in two (16.67%) patients. Metastasis occurred in four (33.33%) patients while the tumor recurred in two (16.67%) patients who later died. Bricker’s ileal conduit urinary diversion was performed in 10 (83.33%) patients while the Studer neobladder was used in two (16.67%) patients. The mean duration of hospitalization was 6 ± 1.48 days. Only one patient (8.33%) developed a postoperative complication. Six (50%) of the patients died while six survived. The median overall survival was 486 days and the five-year overall survival rate was 46.47%. Conclusion: Laparoscopic cystectomy is a mini-invasive technique associated with good cancer control. When performed by well-trained staff using specialized equipment, it can be a safe and effective method of managing muscle-invasive bladder cancer.

Laparoscopic coring-type resection of noncommunicating broadly attached rudimentary horn with recurrent large ovarian endometriomas:A report of two cases

Rudimentary horn of the uterus is a rare congenital malformation that is characterized by significant anatomic variability.We report two cases involving women who presented with a broadly attached rudimentary horn and large ovarian endometriomas that were innovatively treated by laparoscopic coring-type dissection of the rudimentary horn of the uterus.This novel surgical approach ensured the integrity of the myometrium of the unicornuate uterus and avoided uterine rupture during pregnancy and ipsilateral ovarian function impairment.

Laparoscopic cholecystectomy for a left-sided gallbladder

Cholecystectomy is a common procedure.Abnormalities in the anatomy of the biliary system are common but an abnormal location of the gallbladder is much rarer.Despite frequent pre-operative imaging,the aberrant location of the gallbladder is commonly discovered at surgery.This article presents a case of a patient with the gallbladder located to the left of the falciform ligament in the absence of situs inversus totalis that presented with right upper quadrant pain.A laparoscopic cholecystectomy was performed and it was noted that the cystic duct originated from the right side.The presence of a left sided gall bladder is often associated with various biliary,portal venous and other anomalies that might lead to intra-operative injuries.The spectrum of unusual positions and anatomical gallbladder abnormalities is reviewed in order to facilitate elective and emergent cholecystectomy as well as other hepatobiliary procedures.With proper identification of the anatomy,minimally invasive approaches are still considered safe.

Laparoscopic partial cystectomy with mucosal stripping of extraluminal duodenal duplication cysts

Duodenal duplication cysts are rare congenital anomalies.Duodenal duplication should be considered in the differential diagnosis of patients who present with abdominal symptoms with cystic structures neighboring the duodenum.Here,we present an 8-year-old girl with a duodenal duplication cyst treated with partial cystectomy with mucosal stripping performed laparoscopically.Laparoscopic surgery can be considered as a treatment option for duodenal duplication cysts,especially in extraluminal locations.

卵巢子宫内膜异位囊肿患者腹腔镜下剥离术中不同分离法对AMH、FSH及E2水平的影响

目的分析卵巢子宫内膜异位囊肿患者腹腔镜下剥离术中不同分离法对抗苗勒管激素(AMH)、基础卵泡刺激素(FSH)及雌二醇(Estradiol,E2)水平的影响。方法选取2021年1月至2022年1月期间郑州大学第一附属医院收治的90例卵巢子宫内膜异位囊肿患者,根据治疗方案不同分为对照组44例与观察组46例。对比两组围手术期指标、卵巢功能、术后分离卵巢囊肿囊壁附着的正常卵巢组织阳性率与正常卵泡数以及复发率、妊娠率、并发症发生率。结果观察组术中出血量比对照组少,手术时间、排气时间、下床活动时间比对照组短,卵巢皮质剥离厚度与病灶剥离厚度比对照组薄,差异有统计学意义(P<0.05);两组术前AMH、FSH、E2水平比较,差异无统计学意义(P>0.05);术后3个月、6个月,AMH、E2水平均降低,FSH水平升高,且观察组AMH、E2水平比对照组高,FSH水平比对照组低,差异有统计学意义(P<0.05);观察组术后分离卵巢囊肿囊壁附着的正常卵巢组织阳性率低于对照组,正常卵泡数多于对照组,差异有统计学意义(P<0.05);观察组复发率低于对照组,妊娠率高于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论应用腹腔镜下注水分离法可有效改善卵巢子宫内膜异位囊肿患者围手术期指标,减少损伤卵巢功能,具有一定的安全性。

腹腔镜子宫肌瘤剔除术对子宫肌瘤患者盆底功能、卵巢功能的影响

目的探讨腹腔镜子宫肌瘤剔除术(LM)对子宫肌瘤患者盆底功能、卵巢功能的影响。方法纳入2021年1月至2022年10月濮阳市安阳地区医院收治的80例子宫肌瘤患者,按抽签法分两组。对照组40例行开腹子宫肌瘤剔除术(AM),研究组40例行LM,对比两组手术前后疼痛因子[心肌细胞P物质(SP)、前列腺素E_2(PGE_2)]、应激反应指标[去甲肾上腺素(NE)、皮质醇(COR)]、免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、盆底功能指标[盆底障碍影响简易问卷7(PFIQ-7)]及卵巢功能指标[雌二醇(E_2)、促黄体生成素(LH)、促卵泡激素(FSH)]。结果术后1 d、术后3 d时,研究组血清SP、PGE_2、NE、COR水平低于对照组,差异有统计学意义(P<0.05)。术后1d时,两组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)功能指标与术前相比均有所降低,但研究组明显高于对照组,差异有统计学意义(P<0.05);而两组的CD8^(+)功能指标与术前相比有所升高,但研究组明显低于对照组,差异有统计学意义(P<0.05)。术后1个月、术后3个月时,两组PFIQ-7评分均有所升高,但研究组明显低于对照组,差异有统计学意义(P<0.05)。术后3个月、术后6个月时,研究组血清E_2水平高于对照组,而血清LH、FSH水平低于对照组,差异有统计学意义(P<0.05)。结论对子宫肌瘤患者行LM可有效减轻机体疼痛程度、应激反应及对免疫、盆底和卵巢功能的负面影响,优势较为显著,具有进一步的使用价值。

腹腔镜下行根治性膀胱切除术患者伴偶发前列腺癌的相关因素分析

目的探讨腹腔镜下根治性膀胱切除术患者伴偶发前列腺癌的相关因素。方法回顾性分析65例腹腔镜下根治性膀胱切除术患者的临床资料,统计其偶发前列腺癌发生情况。结果65例腹腔镜下行根治性膀胱切除术患者中,偶发前列腺癌共12例,发生率为18.46%(12/65);单因素分析显示:高血压史、糖尿病史、肿瘤直径与腹腔镜下根治性膀胱切除术患者偶发前列腺癌发生无关(P>0.05);而年龄、BMI、吸烟史、饮酒史、前列腺体积与偶发前列腺癌发生有关(P<0.05);多因素Logistic回归分析显示:年龄≥60岁(β=1.531,OR=4.625,95%CI=1.216~17.590)、BMI≥28 kg/m^(2)(β=1.599,OR=4.950,95%CI=1.197~20.474)、有吸烟史(β=1.795,OR=6.020,95%CI=1.579~22.947)、有饮酒史(β=1.764,OR=5.833,95%CI=1.403~24.253)、前列腺体积>4 cm×3 cm×2 cm(β=1.623,OR=5.067,95%CI=1.326~19.365)为腹腔镜下根治性膀胱切除术患者偶发前列腺癌发生的主要危险因素(P<0.05)。结论腹腔镜下根治性膀胱切除术患者偶发前列腺癌发生风险较高,而其发生的因素具有多样性,如年龄≥60岁、BMI≥28 kg/m^(2)、有吸烟史、有饮酒史等。

不同尿流改道方式在膀胱癌患者行机器人辅助腹腔镜下全膀胱切除术后的效果观察

目的探析不同尿流改道方式应用于膀胱癌患者机器人辅助腹腔镜(以下简称腹腔镜)下全膀胱切除术后的效果。方法采用前瞻性研究法,选取2018年5月~2022年5月南京大学医学院附属鼓楼医院收治的行腹腔镜下全膀胱切除术的膀胱癌患者102例,采用随机数表法分为对照组和试验组两组,各51例。对照组行输尿管皮肤造口术,试验组行原位回肠新膀胱重建术。比较两组患者围术期指标、生活质量变化,并统计并发症发生率情况。结果试验组手术时间及住院时间分别为(372.07±45.48)min、(24.83±4.16)d较对照组(339.47±52.07)min、(21.05±4.72)d长,术中出血量为(857.06±125.39)ml较对照组的(749.14±140.06)ml多,差异有统计学意义(t=3.367、4.291、4.100,P<0.001)。试验组治疗后生理功能、心理健康及总体健康评分分别为(64.08±7.25)分、(63.93±7.02)分和(61.17±6.93)分,较对照组的(60.13±6.59)分、(59.97±6.84)分和(57.08±7.11)分高,差异有统计学意义(t=2.879、2.885、2.942,P<0.05);试验组术后尿路感染发生率为1.96%(151),低于对照组的15.69%(851),差异有统计学意义(χ^(2)=4.387,P=0.036)。结论原位回肠新膀胱重建术应用于膀胱癌患者腹腔镜下全膀胱切除术后虽手术时间长,术中出血量多,但可提高生活质量,且术后尿路感染发生率低,安全性更高。

腹腔镜术后戈舍瑞林联合戊酸雌二醇治疗育龄期子宫内膜异位症的临床观察

目的 观察腹腔镜术后戈舍瑞林联合戊酸雌二醇治疗育龄期子宫内膜异位症(EMs)的疗效和安全性。方法 回顾性收集2020年1月-2022年12月在我院接受腹腔镜手术治疗的144例育龄期EMs患者资料,根据术后用药方案分为对照组(70例)和联合组(74例)。对照组患者于腹腔镜手术后首次月经来潮的第1~5天给予醋酸戈舍瑞林缓释植入剂,联合组患者在对照组用药的基础上给予戊酸雌二醇片。观察两组患者的近期疗效和远期疗效,记录术前和术后的疼痛评分、卵巢储备功能及不良反应发生情况。结果 两组患者的近期总有效率、术后1年复发率及性欲下降、阴道干涩、胃肠道反应、皮疹、心律失常的发生率比较,差异均无统计学意义(P>0.05);联合组患者术后1年自然妊娠率显著高于对照组,早期流产率及潮热出汗、情绪波动、失眠乏力、关节肌肉疼痛、头晕头痛的发生率均显著低于对照组(P<0.05)。术后6个月,两组患者的疼痛程度评分和抗米勒管激素、卵泡刺激素、黄体生成素、雌二醇水平均显著低于同组术前,窦卵泡计数显著高于同组术前,且联合组的抗米勒管激素、黄体生成素、雌二醇水平和窦卵泡计数均显著高于对照组,疼痛程度评分及卵泡刺激素水平均显著低于对照组(P<0.05)。结论 腹腔镜术后戈舍瑞林联合戊酸雌二醇治疗育龄期EMs疗效显著,且安全性较好。

聚焦解决护理模式在腹腔镜卵巢囊肿剥除术患者中的应用

目的探讨聚焦解决护理模式在腹腔镜卵巢囊肿剥除术中的应用效果。方法选取淄博市桓台县妇幼保健院2021年2月至8月收治的82例腹腔镜卵巢囊肿剥除术患者作为研究对象,按照随机数字表法分为对照组与观察组,每组各41例。对照组采用常规护理,观察组采用聚焦解决护理模式,比较两组生活质量、心理状态及护理满意度。结果护理后,观察组健康调查量表36各项评分均高于对照组,差异有统计学意义(P<0.05)。观察组护理满意度评分高于对照组,差异有统计学意义(P<0.05)。观察组焦虑自评量表、抑郁自评量表评分低于对照组,差异有统计学意义(P<0.05)。结论聚焦解决护理模式在腹腔镜卵巢囊肿剥除术患者中的应用效果较好,可改善生活质量和心理状态,提高护理满意度,值得应用。

GnRHa联合腹腔镜手术治疗子宫内膜异位症患者的效果

目的:观察促性腺激素释放激素激动剂(GnRHa)联合腹腔镜手术治疗子宫内膜异位症(EMT)患者的效果。方法:选取2021年1月至2022年5月该院妇产科收治的106例EMT患者进行前瞻性研究,按随机数字表法将其分为对照组(n=53)和观察组(n=53)。对照组采用腹腔镜手术治疗,观察组在对照组基础上联合GnRHa治疗,比较两组临床疗效、治疗前后卵巢功能指标[雌二醇(E2)、促黄体生成素(LH)、卵泡刺激素(FSH)]水平、治疗期间不良反应发生率,以及术后随访12个月的痛经率和妊娠率。结果:观察组治疗总有效率为90.57%(48/53),高于对照组的75.47%(40/53),差异有统计学意义(P<0.05);治疗后,两组E2、LH和FSH水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05);随访12个月,观察组痛经率低于对照组,妊娠率高于对照组,差异均有统计学意义(P<0.05)。结论:GnRHa联合腹腔镜手术治疗EMT患者可提高治疗总有效率和妊娠率,降低卵巢功能指标水平和痛经率,效果优于单纯腹腔镜手术治疗。

宫腔镜子宫肌瘤电切术与腹腔镜子宫肌瘤剔除术疗效比较

目的 对比分析子宫肌瘤采取宫腔镜下子宫肌瘤电切术(transcervical resection of myoma, TCRM)与腹腔镜下子宫肌瘤剔除术(laparoscopic lyomectomy, LM)的疗效。方法 回顾性选取2020年1月—2023年8月昆山市第二人民医院收治的84例子宫肌瘤患者的临床资料,按手术方案不同分为观察组和对照组,各42例。观察组采用TCRM治疗,对照组采用LM治疗。对比两组手术指标、卵巢储备功能及术后并发症发生情况。结果 观察组的手术时间为(42.41±9.05)min、术中出血量为(74.12±20.06)mL、术后排气时间为(14.56±3.06)h、住院时间为(4.55±0.78)d,均优于对照组的(61.84±12.35)min、(95.61±22.36)mL、(19.80±5.12)h、(6.30±1.28)d,差异有统计学意义(t=8.224、4.636、5.693、7.566,P均<0.05)。两组患者的雌二醇、黄体生成素和卵泡刺激素对比,差异无统计学意义(P均>0.05)。观察组术后并发症总发生率为4.76%(2/42),低于对照组的19.05%(8/42),差异有统计学意义(χ^(2)=4.087,P<0.05)。结论 LM和TCRM治疗子宫肌瘤均能取得良好效果,且对卵巢功能影响较小,但TCRM手术时间更短,术后康复更快,并发症较少。

GnRH-a联合经脐腹腔镜卵巢囊肿剥除术治疗卵巢良性囊肿的效果及对术后恢复、妊娠率的影响

目的探讨GnRH-a联合经脐腹腔镜卵巢囊肿剥除术治疗卵巢良性囊肿的效果及对术后恢复、妊娠率的影响。方法选取本院150例卵巢良性囊肿患者为研究对象,随机分为两组,各75例。对照组采用经脐腹腔镜卵巢囊肿剥除术治疗,试验组采用GnRH-a联合经脐腹腔镜卵巢囊肿剥除术治疗,比较治疗效果。结果试验组治疗总有效率为96.00%,高于对照组的86.67%,差异有统计学意义(P<0.05);试验组月经经血量异常率、月经周期异常率低于对照组,临床妊娠率高于对照组,差异有统计学意义(P<0.05);术后3个月经周期时,试验组黄体生成素、雌二醇及卵泡刺激素水平低于对照组(P<0.05)。结论GnRH-a联合经脐腹腔镜卵巢囊肿剥除术治疗卵巢良性囊肿,效果显著,值得推广应用。