腹腔镜手术治疗卵巢肿物512例临床分析

目的探讨腹腔镜手术在卵巢肿物治疗中的价值及安全性。方法回顾性分析郑州大学第二附属医院妇科2006年1月至2009年10月诊断为卵巢良性病变接受腹腔镜手术的512例患者的临床资料。结果 512例患者中,502例(98.05%)腹腔镜术后诊断为卵巢良性病变,除1例因盆腔粘连严重中转开腹外,其余均顺利完成手术,无术中副损伤及术后并发症;10例(1.95%)术前未预计卵巢非良性肿瘤,其中术中确诊7例,术后确诊3例。10例非良性肿瘤中,9例为卵巢恶性肿瘤,其中4例在腹腔镜下完成了手术,2例中转开腹,3例行二次手术;1例为双侧卵巢交界性肿瘤,中转开腹行双侧卵巢肿瘤剥除术。10例患者中,6例行保留生育功能手术,4例成功受孕,其中2例已分娩。10例非良性肿瘤患者术后平均随访(22.4±2.5)个月,均无复发。结论腹腔镜手术可作为术前诊断为良性卵巢肿物的首选安全的手术方式,对术前未预计的卵巢非良性肿瘤患者预后无明显影响。

Clinical analysis of laparoscopic management of ovarian mass

Objective To explore the feasibility and security of laparoscopic management of ovaries masses.Methods A total of 512 patients with ovary mass were treated with laparoscopy from January 2006 to October 2009 at our hospital,All patients were initially diagnosed benign ovarian mass preoperatively.Their clinical data were reviewed retrospectively.Results Of the 512 patients,502 had benign tumors（98.05%）,except 1 case which was transitted to laparotomy due to severe pelvic adhesions,the rest underwent laparoscopic management successfully.10 cases（1.95%）with unanticipated non-benign tumor,among which 7 were diagnosed histologically intraoperatively and 3 postoperatively.Among the 10 non-benign tumors,9 cases were invasive tumor,4 of them underwent laparoscopic surgery,2 of them had convered to laparotomy,3 of them underwent second operation after the final pathology.The other 1 case was bilateral ovarian exogenous low malignant potential,transit laparotomy.In these 10 cases,6 cases underwent reproductive reserved operation and four were pregnant,two of them had birth.The mean follow up time was 22.4 months for patients with non-benign tumor.There is no evidence of recurrence during follow up.Conclusions Laparoscopic surgery can be the preferred surgical method for the preoperative diagnosis of benign ovarian mass,it had no effect on the prognosis of patients with preoperative unanticipated non-benign tumor of the ovary.