摘要
目的 探讨影响卵巢交界性肿瘤(borderline ovarian tumors,BOTs)患者行保留生育功能手术(fertility-spar‐ing surgery,FSS)后复发以及妊娠的相关因素。方法 选取2005年1月至2021年11月首都医科大学附属北京朝阳医院行FSS的BOTs患者,分析其影响复发及妊娠的高危因素。结果 共纳入BOTs患者60例,年龄14~46岁,中位年龄为29岁。在110个月的中位随访时间中出现了7例复发,复发率为11.67%,未发生死亡病例。其中40例患者接受患侧附件切除,4例复发;10例患者接受患侧肿物剥除,无复发;4例患者接受双侧肿物剥除,1例复发;6例接受一侧附件切除以及对侧的卵巢肿物剥除,2例复发。复发患者双侧BOTs占比高于未复发患者(42.86%比13.21%),差异有统计学意义(P<0.05)。手术路径、国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)分期、浸润性种植及病理是否存在微乳头均不影响患者的复发率。本研究未发现影响妊娠率及妊娠结局的高危因素。结论 FSS对于年轻有生育需求的BOTs患者是安全可行的术式。建议有生育需求的尤其具有复发高危因素的患者术后在严密随访的基础上尽早妊娠,完成生育。
Objective To explore the related factors affecting the recurrence and pregnancy of patients with borderline ovarian tumors(BOTs)after fertility-sparing surgery(FSS).Methods The patients with BOTs after FSS in Beijing Chaoyang Hospital affiliated to Capital Medical University from January 2005 to November 2021 were selected,and the related factors affecting the recurrence and pregnancy of patients were analyzed.Results The patients with BOTs were included,aged from 14 to 46 years,with a median age of 29 years.During the median follow-up of 110 months,seven cases recurred,and the recurrence rate was 11.67%,and no death occurred.Among the 60 patients,40 underwent unilateral salpingo-oophorectomy,with four cases of recurrence;10 patients underwent unilateral cystectomy,with no recurrence;four patients underwent bilateral cystectomy,with one case of recurrence;six patients underwent unilateral salpingo-oophorectomy combined with contralateral ovarian cystectomy,with two cases of recurrence.The proportion of bilateral BOTs in recurrent patients was higher than that in non-recurrent patients(42.86%vs.13.21%),and the difference was statistically significant(P<0.05).Surgical approach,International Federation of Gynecology and Obstetrics stage,invasive implants,and the presence of micropapillary pathology did not significantly affect the recurrence rate.No risk factors for pregnancy in BOTs receiving FSS were found.Conclusions FSS is a feasible approach for BOTs patients who desire to preserve fertility.It is suggested that patients with fertility needs,especially those with high risk factors of recurrence,should get pregnant as soon as possible after operation on the basis of close follow-up and complete fertility.
作者
鲁琦
邓宇鹏
张志强
瞿红
王淑珍
刘崇东
Lu Qi;Deng Yupeng;Zhang Zhiqiang;Qu Hong;Wang Shuzhen;Liu Chongdong(Department of Obstetrics and Gynecology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)
出处
《北京医学》
2025年第6期472-476,共5页
Beijing Medical Journal
关键词
卵巢交界性肿瘤
保留生育功能手术
复发
妊娠
borderline ovarian tumor(BOTs)
fertility-sparing surgery(FSS)
recurrence
pregnancy
