摘要
目的探讨改良腹腔镜治疗卵巢良性畸胎瘤的效果和手术技巧，防止术中发生畸胎瘤破裂的并发症，最大限度地保留卵巢功能。方法2005年2月至2009年2月分别采用改良腹腔镜畸胎瘤剥除术与现行常规腹腔镜畸胎瘤剥除术治疗我院住院的较大卵巢良性畸胎瘤患者39例与45例，比较其手术中瘤囊破裂情况、手术时间、出血量、使用电凝次数、对体温与肠管的影响，以及术后住院天数。结果39例卵巢良性畸胎瘤患者改良腹腔镜手术均获成功，术中囊肿内容物无一破入腹腔，无一使用电凝止血，术中出血量（35．13±5．49）ml、手术时间（36．07±12．53）min，明显少于常规腹腔镜手术组[囊肿破裂发生率46．7％（21／45），使用电凝次数（5．0±3．0）次，持续电凝时间（5．5±2．5）s，术中出血量（40．73±6．04）ml，手术时间（67．47±20．73）min]，2组比较，差异均有统计学意义（P〈0．05或P〈0．01）；两种手术方式对术后体温、肛门排气时间、术后住院天数的影响不明显，无明显差异。结论改良腹腔镜手术治疗较大卵巢良性畸胎瘤除具有腹腔镜手术治疗创伤小、对肠道影响小、康复快等优点外，更缩短了手术时间，改良后腹腔外剥除并缝合的手术方法可有效地防止术中瘤囊破裂而引起的并发症，减少了电凝损伤，最大限度保留了有功能的卵巢组织。
Objective To investigate the effectiveness and surgical techniques of the improved laparoscopic treatment of ovarian dermoid cyst to prevent the occurrence of intraoperative rupture of teratomat, so to preserve the ovarian function at the maximum. Methods The modified laparoscopic extra-cavity and cavity outside the teratoma removed surgical suture treatment from February 2005 to February 2009,39 cases with large dermoid cyst were treated by improved surgery and 45 cases treated by normal removal of laparoscope. The rupture, surgery time, bleeding volume, frequency of use of electrocoagulation and the effect of body temperature on intestinal canal and hospitalization day after operation as well. Results 39 cases of dermoid cyst were successfully managed by improved laparoscopic surgery,during which no cyst contents broke into the abdominal cavity, no one was placed on electrocoagulation to stop bleeding, bleeding volume was （ 35.13 ± 5.49 ） ml, operative time was （ 36.07 ± 12.53 ） rain, significantly less than that of normal laparoscopic surgery group [ the cyst rupture rate was 46.7 % （21/45）, the frequency of electrocoagulation was （ 5.0 ± 3.0） times, the duration of electrocoagulation was （ 5.5 ± 2.5 ） s, bleeding loss was （40.73 ±6.04）ml and the time for operation was （67.47 ± 20.73 ） min] ,with significant difference between the two groups（ P 〈0.05 or 0.01 ） ;howevere,there was no remarkable difference in the effect of the two types of surgery on postoperative body temperature, anal exhaust time, postoperative hospitalization day. Conclusions In addition to minimally invasive laparoscopic surgery in the treatment of gastro-intestinal effects of small, quick recovery, the improved laparoscopic surgery for dermoid cyst shortens the operation time. The improved abdominal cavity and suture outside the strip surgical method can effectively prevent the complication caused by intraoperative tumor capsule rupture, reduce electrocoagulation injury, and preserve the ovarian function at the maximum.
出处
《中国综合临床》
2009年第11期1218-1220,共3页
Clinical Medicine of China
