中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2009年
11期
1218-1220
,共3页
刘喻%王明波%王晓萍%钟富莲
劉喻%王明波%王曉萍%鐘富蓮
류유%왕명파%왕효평%종부련
卵巢良性畸胎瘤%囊肿剥除术%改良%腹腔镜
卵巢良性畸胎瘤%囊腫剝除術%改良%腹腔鏡
란소량성기태류%낭종박제술%개량%복강경
Dermoid cyst%Cyst excision surgery%improvement%Laparoscope
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.
目的 探討改良腹腔鏡治療卵巢良性畸胎瘤的效果和手術技巧,防止術中髮生畸胎瘤破裂的併髮癥,最大限度地保留卵巢功能.方法 2005年2月至2009年2月分彆採用改良腹腔鏡畸胎瘤剝除術與現行常規腹腔鏡畸胎瘤剝除術治療我院住院的較大卵巢良性畸胎瘤患者39例與45例,比較其手術中瘤囊破裂情況、手術時間、齣血量、使用電凝次數、對體溫與腸管的影響,以及術後住院天數.結果 39例卵巢良性畸胎瘤患者改良腹腔鏡手術均穫成功,術中囊腫內容物無一破入腹腔,無一使用電凝止血,術中齣血量(35.13±5.49)ml、手術時間(36.07±12.53)min,明顯少于常規腹腔鏡手術組[囊腫破裂髮生率46.7%(21/45),使用電凝次數(5.0±3.0)次,持續電凝時間(5.5±2.5)s,術中齣血量(40.73±6.04)ml,手術時間(67.47±20.73)min],2組比較,差異均有統計學意義(P<0.05或P<0.01);兩種手術方式對術後體溫、肛門排氣時間、術後住院天數的影響不明顯,無明顯差異.結論 改良腹腔鏡手術治療較大卵巢良性畸胎瘤除具有腹腔鏡手術治療創傷小、對腸道影響小、康複快等優點外,更縮短瞭手術時間,改良後腹腔外剝除併縫閤的手術方法可有效地防止術中瘤囊破裂而引起的併髮癥,減少瞭電凝損傷,最大限度保留瞭有功能的卵巢組織.
목적 탐토개량복강경치료란소량성기태류적효과화수술기교,방지술중발생기태류파렬적병발증,최대한도지보류란소공능.방법 2005년2월지2009년2월분별채용개량복강경기태류박제술여현행상규복강경기태류박제술치료아원주원적교대란소량성기태류환자39례여45례,비교기수술중류낭파렬정황、수술시간、출혈량、사용전응차수、대체온여장관적영향,이급술후주원천수.결과 39례란소량성기태류환자개량복강경수술균획성공,술중낭종내용물무일파입복강,무일사용전응지혈,술중출혈량(35.13±5.49)ml、수술시간(36.07±12.53)min,명현소우상규복강경수술조[낭종파렬발생솔46.7%(21/45),사용전응차수(5.0±3.0)차,지속전응시간(5.5±2.5)s,술중출혈량(40.73±6.04)ml,수술시간(67.47±20.73)min],2조비교,차이균유통계학의의(P<0.05혹P<0.01);량충수술방식대술후체온、항문배기시간、술후주원천수적영향불명현,무명현차이.결론 개량복강경수술치료교대란소량성기태류제구유복강경수술치료창상소、대장도영향소、강복쾌등우점외,경축단료수술시간,개량후복강외박제병봉합적수술방법가유효지방지술중류낭파렬이인기적병발증,감소료전응손상,최대한도보류료유공능적란소조직.
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 trea-ted 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 hospitaliza-tion day after operation as well. Results 39 cases of dermoid cyst were successfully managed by improved laparo-scopie surgery, during which no cyst contents broke into the abdominal cavity, no one was placed on electrocoagula-tion to stop bleeding, bleeding volume was (35.13±5.49) ml, operative time was (36.07±12.53) min, significantly leas than that of normal laparoscopic surgery group [the cyst rupture rate was 46.7% (21/45), the frequency of elec-trocoagulation was (5.0±3.0) times, the duration of electrocoagulatian 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 im-proved 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 rup-ture,reduce electrocoagulation injury,and preserve the ovarian function at the maximum.
