中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2014年
4期
254-259
,共6页
陈瑞芳%朱婷婷%于海林%朱静%鹿欣
陳瑞芳%硃婷婷%于海林%硃靜%鹿訢
진서방%주정정%우해림%주정%록흔
卵巢肿瘤%肿瘤复发,局部%再手术%保留生育能力%妊娠结局
卵巢腫瘤%腫瘤複髮,跼部%再手術%保留生育能力%妊娠結跼
란소종류%종류복발,국부%재수술%보류생육능력%임신결국
Ovarian neoplasms%Neoplasm recurrence,local%Reoperation%Fertility preservation%Pregnancy outcome
目的探讨复发性卵巢交界性肿瘤( BOT)患者再次行保留生育功能手术的可行性及临床意义。方法回顾性分析2002年1月至2012年12月复旦大学附属妇产科医院收治的12例复发性BOT患者的临床病理特征及再次施行保留生育功能手术后的月经、生育情况以及肿瘤复发和生存情况。结果(1)12例复发性BOT患者的平均年龄为26岁,再次行保留生育功能手术前均未生育。再次手术后病理检查仍均为BOT,其中10例患者的复发病灶仍局限于卵巢。(2)12例复发性BOT患者中,8例患者再次手术后月经仍规律,4例患者术后月经量减少或经期延长。6例患者术后有妊娠意愿,其中4例(4/6)成功妊娠并顺利分娩。随访时间平均53个月(23~97个月),再次手术后3例患者提示有再次复发可能,其中2例仅为B超检查提示卵巢囊肿,未经手术病理证实;另1例患者再次复发后行第3次保留生育功能手术,术后病理诊断仍为BOT,但未发生与肿瘤相关的死亡。结论对于年轻、有强烈生育要求的复发性BOT患者,可再次行保留生育功能手术,再次手术后妊娠成功率仍较高,但需严密随访。
目的探討複髮性卵巢交界性腫瘤( BOT)患者再次行保留生育功能手術的可行性及臨床意義。方法迴顧性分析2002年1月至2012年12月複旦大學附屬婦產科醫院收治的12例複髮性BOT患者的臨床病理特徵及再次施行保留生育功能手術後的月經、生育情況以及腫瘤複髮和生存情況。結果(1)12例複髮性BOT患者的平均年齡為26歲,再次行保留生育功能手術前均未生育。再次手術後病理檢查仍均為BOT,其中10例患者的複髮病竈仍跼限于卵巢。(2)12例複髮性BOT患者中,8例患者再次手術後月經仍規律,4例患者術後月經量減少或經期延長。6例患者術後有妊娠意願,其中4例(4/6)成功妊娠併順利分娩。隨訪時間平均53箇月(23~97箇月),再次手術後3例患者提示有再次複髮可能,其中2例僅為B超檢查提示卵巢囊腫,未經手術病理證實;另1例患者再次複髮後行第3次保留生育功能手術,術後病理診斷仍為BOT,但未髮生與腫瘤相關的死亡。結論對于年輕、有彊烈生育要求的複髮性BOT患者,可再次行保留生育功能手術,再次手術後妊娠成功率仍較高,但需嚴密隨訪。
목적탐토복발성란소교계성종류( BOT)환자재차행보류생육공능수술적가행성급림상의의。방법회고성분석2002년1월지2012년12월복단대학부속부산과의원수치적12례복발성BOT환자적림상병리특정급재차시행보류생육공능수술후적월경、생육정황이급종류복발화생존정황。결과(1)12례복발성BOT환자적평균년령위26세,재차행보류생육공능수술전균미생육。재차수술후병리검사잉균위BOT,기중10례환자적복발병조잉국한우란소。(2)12례복발성BOT환자중,8례환자재차수술후월경잉규률,4례환자술후월경량감소혹경기연장。6례환자술후유임신의원,기중4례(4/6)성공임신병순리분면。수방시간평균53개월(23~97개월),재차수술후3례환자제시유재차복발가능,기중2례부위B초검사제시란소낭종,미경수술병리증실;령1례환자재차복발후행제3차보류생육공능수술,술후병리진단잉위BOT,단미발생여종류상관적사망。결론대우년경、유강렬생육요구적복발성BOT환자,가재차행보류생육공능수술,재차수술후임신성공솔잉교고,단수엄밀수방。
Objective To analyse the clinical practicability and significance of fertility-sparing surgery for women with recurrent borderline ovarian tumors ( BOT).Methods The clinical and pathological recordings of 12 patients suffered from recurrent BOT in the Obstetrics and Gynecology Hospital of Fudan University from Jan.2002 to Dec.2012 were analyzed retrospectively.The menstruation situation , fertility function , recurrence rate and survival after second conservative surgery were collected and analyzed .Results The average onset age of these 12 patients was 26 years, and none of them had procreation before the second operation.The pathological diagnosis were still BOT and the recurrent sites of 10 patients were still restricted to the ovaries.Of the 12 cases, 8 cases of them had normal menstruation functions and 4 cases had less menstrual volumes or longer menstrual periods.Among 6 cases desired for pregnancy after the second operation,4 cases of them were successful.The spontaneous pregnancy rate was 4/6.The mean duration of follow-up was 53 months(range:23-97 months).All recurrent BOT, three cases developed recurrence once more,two cases of them were just be hinted by B ultrasounds and only one cases was approved to be BOT again by a once more surgical pathology.But no disease related deaths occurred.Conclusions The second fertility-sparing surgery may be feasible for women with recurrent BOT who are young and strongly desired for preservation of fertility.The spontaneous pregnancy rate is satisfactory.However, carefully follow-up is still needed.