腹腔镜手术中卵巢良性畸胎瘤破裂临床分析

目的分析腹腔镜下卵巢良性畸胎瘤手术时囊肿破裂的相关因素和对患者预后的影响.方法回顾性分析1999年～2002年间接受腹腔镜下卵巢良性畸胎瘤剥除术121例临床资料,并使用SPSS统计软件处理数据.结果术中发生囊肿破例48例,未破裂73例.两组比较,破裂组手术时间长于未破裂组,术中囊肿破裂与左侧肿瘤和盆腔粘连有关,而与患者年龄、孕产次、肿瘤大小、出血量、术后月经改变、腹痛以及术后妊娠无明显关系.结论手术者熟练的腹腔镜技术,术中使用取物袋,可能减少囊肿破裂,如发生破裂,及时、大量生理盐水冲洗盆腹腔可以减少术后病率发生,不会影响妊娠.

Clinical analysis of the causing factors of ovario - cystic teratoma rupture during laparoscopic surgery

Objective To analyze causing factors of ovario-cystic teratoma rupture during laparoscopic cystectomy and effects to the prognosis of the patients. Methods A retrospective case comparison of 121 patients who received laparoscopic surgery for cystic teratoma at Peking University People's Hospital from January, 1999 to October, 2002. Statistical analysis was performed using SPSS. Result A total of 73 benign cystic teratomases was successfully removed without intra-operative rupture, while 48 teratomases were intra-operative ruptured. Mean surgical time was significantly longer in rupture group. The incidence of cystic teratoma rupture was related to left side pelvic anatomy and pelvic adhesions, whereas no correlation was observed with patients' ages, size of cyst gravidity and parity, volume of bleeding, post surgical menstruation alteration, abdominal pain, and post surgical pregnancy. Conclusion Skill, experience in laparoscopic practices and the usage of laparoscopic bag help to avoid cystic teratoma rupture. When rupture occurs, timely cleanness with saline can decrease post-surgery complications and does not affect subsequent pregnancy.