良性巨大卵巢囊肿微创手术治疗2例报告

我院近 2年 ,对 2例巨大卵巢囊肿采用耻上小切口配合腹腔镜探查下进行手术治疗 ,效果满意 ,现报告如下。临床资料和方法一、一般资料例 1,4 6岁 ,以腹部明显增大半年余为主诉入院。腹部扪及如足月妊娠大小之包块 ,上界剑下三横指 ,距耻骨联合 36ｃｍ ,囊性感 ,Ｂ超探及腹部自耻骨联合上方至剑下和左右侧腹部一巨大液性回声 ,内有许多分隔 ,内壁未见明显乳状突起 ,有少量腹水征。提示巨大卵巢囊腺瘤 (右侧 )。例 2 ,2 9岁 ,系妊娠时Ｂ超检查提示妊娠合并右卵巢囊肿。顺产后半年 ,复查Ｂ超卵巢囊肿明显增大而入院。腹部扪及如孕 8月左右大小之…     

腹腔镜手术治疗良性卵巢囊肿临床体会

目的总结腹腔镜手术治疗良性卵巢囊肿的临床体会。方法将180例良性卵巢囊肿患者按照不同手术方式分为对照组和观察组,各90例。对照组行常规开腹手术,观察组行腹腔镜手术,比较两组手术时间、术中出血量、术后并发症等指标。结果两组患者手术时间比较,差异无统计学意义(P0.05)。腹腔镜组术中出血量少于传统传统开腹组。腹腔镜组住院时间、术后下床活动时间及术后并发症发生率均低于传统开腹组,两组比较,差异均有统计学意义(P0.05)。结论腹腔镜手术治疗良性卵巢囊肿创伤小,术中出血量小,术后恢复时间短,术后并发症低,值得临床应用。     

探讨腹腔镜治疗良性卵巢囊肿的临床效果

目的分析腹腔镜手术治疗良性卵巢囊肿的临床效果。方法将76例良性卵巢囊肿患者随机对照组和腹腔镜组2组,各38例,对照组实施传统开腹手术,腹腔镜组行腹腔镜切除术,比较治疗效果。结果腹腔镜组患者术后肛门排气时间、住院时间及术后并发症发病率均低于对照组,2差异有统计学意义(P0.05)。结论使用腹腔镜手术治疗良性卵巢囊肿可减少术后并发症发生率,提高治疗效果。     

腹腔镜下良性卵巢囊肿剥除术32例临床分析

目的探讨腹腔镜下良性卵巢囊肿剥除术的方法和效果。方法选取2010-01—2015-06收治的64例良性卵巢囊肿患者,随机分为2组,各32例。均实施卵巢囊肿剥除术。观察组在腹腔镜下施术;对照组行传统开腹手术。分析2组的治疗效果。结果2组患者均顺利完成手术,切口全部Ⅰ期愈合。观察组中无中转开腹病例,虽手术时间略长于对照组,但差异无统计学意义(P0.05)。观察组患者术中出血量、术后肛门恢复排气时间、住院时间及镇痛药物使用率均显著低于对照组,差异有统计学意义(P0.05)。术后3个月来院复查,2组患者均未发生月经周期异常。FSH、LH和E2水平基本恢复正常。结论腹腔镜下卵巢囊肿剥除术切口小而隐蔽、术中出血量少,创伤小、患者痛苦小、术后恢复快,效果满意。     

腹腔镜手术治疗巨大良性卵巢囊肿11例分析

腹腔镜手术治疗巨大良性卵巢囊肿报道较少,我院2002年10月～2003年8月应用腹腔镜手术治疗11例,均取得满意疗效,现报道如下.     

经阴道超声联合腹腔镜下侧卵巢囊肿剥除术在卵巢囊肿治疗中的应用效果

目的 探讨经阴道超声联合腹腔镜下侧卵巢囊肿剥除术在卵巢囊肿治疗中的应用效果。方法 选取医院2019年6月至2021年6月收治的卵巢囊肿患者62例,根据不同手术方法将其分为观察组（n=31）与对照组（n=31）。对照组实施开腹卵巢囊肿剥除术治疗,观察组实施经阴道超声联合腹腔镜下侧卵巢囊肿剥除术治疗,对两组手术情况、卵巢功能相关指标、术后并发症进行比较。结果 在手术时间、首次排气时间、术后下床时间、住院时间方面,观察组与对照组比较均显著缩短,在术中出血量方面,观察组与对照组比较显著降低（P<0.05）;在卵巢功能指标方面,两组术后促黄体素（LH）、促卵泡刺激素（FSH）水平均较术前显著升高,雌二醇（E2）水平显著降低（P<0.05）,其中观察组上述指标改变程度均显著低于对照组（P<0.05）;在术后并发症方面,观察组发生率3.23%较对照组发生率22.58%显著降低（P<0.05）。结论 对卵巢囊肿患者实施经阴道超声联合腹腔镜下侧卵巢囊肿剥除术治疗效果显著,有助于患者术后快速康复,降低对患者卵巢功能的影响,疗效安全,值得临床推广应用。     

经脐单孔腹腔镜卵巢囊肿剥除术1例报告

随着腹腔镜技术在妇科领域的应用日益广泛,减少手术创伤,减轻术后疼痛,手术切口更加美观成为临床医生和患者共同的追求,腹壁无瘢痕手术（no scar surgery）因而成为微创外科的研究热点。我院妇科于2010年3月开展1例经脐单孔腹腔镜下卵巢畸胎瘤剥除术,疗效满意。     

剥离式经尿道前列腺切除术与经尿道前列腺电切术治疗良性前列腺增生的比较研究

目的:比较经尿道前列腺电切术(TURP)与使用专用前列腺增生腺体剥离器行剥离式经尿道前列腺切除术(剥离式TURP,TUERP)治疗良性前列腺增生(BPH)的疗效与安全性。方法:BPH患者630例,均具备手术指征,随机分为TURP组(305例)和剥离式TURP组(325例)。术前两组年龄、前列腺体积、国际前列腺症状评分(IPSS)、最大尿流率(Qmax)数值比较,差异无统计学意义(P均0.05)。记录两组手术时间、手术切除率、术后需要持续膀胱冲洗时间、术后生活质量评分(QOL)、手术并发症数据,进行统计学分析。结果:手术后的资料分析显示,TUERP手术切除率优于TURP组的手术切除率[(60.1±12.3)%vs(47.0±13.3)%,P0.05)];TUERP组平均手术时间比TURP组短[(40.4±14.2)min vs(57.9±15.9)min,P0.05];术后冲洗时间较短[(2.2±1.1)d vs(2.7±0.6)d,P0.05]。TUERP组手术前后血清Na+和血红蛋白浓度变化无统计学意义,TURP组血清Na+和血红蛋白浓度变化有统计学意义[血Na+:(141.2±3.5)mmol/L vs(136.9±4.7)mmol/L,P0.01,血红蛋白:(137.6±8.8)g/L vs(124.8±9.6)g/L,P0.01]。术后3个月,两组的IPSS评分、QOL评分、Qmax评分均较术前有显著改善(P均0.01),组间比较无显著性差异。(P0.05)。结论:剥离式TURP治疗BPH和TURP比较,具有手术时间短、手术切除率高、术中出血少、术后恢复快、并发症少等优点,在临床上有良好的应用前景。     

经阴道自然腔道内镜卵巢囊肿剥除术十例临床分析

目的评估经阴道自然腔道内镜(natural orifice transluminal endoscopic surgery,NOTES)卵巢囊肿剥除术的可行性、安全性及术后恢复情况。 方法回顾分析2017年9－12月在上海市第一妇婴保健院妇科行NOTES卵巢囊肿剥除术患者10例,所有患者取阴道后穹窿入路2.5 cm切口,置入硅胶密封圈后,装上Port,建立气腹后用传统腹腔镜行患侧卵巢囊肿剥除术。统计卵巢囊肿大小、手术时间、术前与术后血色素差值、术中出血量、术后24 h视觉模拟疼痛评分(visual analog scale,VAS)及术后恢复排气时间。 结果其中1例患者因双侧卵巢成熟性囊性畸胎瘤合并多囊卵巢综合征,由于卵巢门出血略活跃、缝合困难影响手术进展,中转为传统腹腔镜手术之外,其他患者均经阴道腹腔镜完成,手术均无并发症、无输血。9例患者的平均手术时间78.3 min,术前与术后血色素的平均差值18.3 g/L,平均术中出血量23.3 ml,术后24 h VAS平均0.55分,术后平均恢复排气时间17.5 h,平均住院时间4.7 d。 结论NOTES卵巢囊肿剥除术后患者的切口疼痛感较轻,具有术后恢复快、腹部无瘢痕、美观的优势,合适的病例选择加上灵活的手术技巧,NOTES卵巢良性囊肿剥除是安全可行的。     

腹腔镜卵巢囊肿剥除术治疗良性卵巢囊肿效果观察

目的探讨腹腔镜下卵巢囊肿剥除术的临床效果。方法对56例良性卵巢囊肿患者实施腹腔镜卵巢囊肿剥除术,回顾性分析患者的临床资料。结果 56例均成功完成手术,无中转开腹病例。术中出血量(24.12±9.40)m L,术后排气时间(13.78±3.92)h,住院时间(5.58±2.68)d。术后病理诊断均为良性卵巢囊肿。3例出现轻度皮下气肿,2例出现轻度疼痛,均未予特殊处理,自行好转或缓解。未发生腹腔感染、脏器损伤等其他严重并发症。结论腹腔镜卵巢囊肿剥除术治疗良性卵巢囊肿,创伤小、安全性高、术后恢复快。     

腹腔镜手术治疗卵巢囊肿386例

目的总结腹腔镜下卵巢囊肿手术的经验. 方法回顾分析1999年7月～2004年12月我院386例囊腹腔镜卵巢囊肿手术的临床资料. 结果 384例腹腔镜手术成功,2例因既往有手术史或盆腔粘连中转开腹.术中出血平均20.6 ml(10～60 ml).手术时间平均55 min(20～140 min ).术后住院平均3 d(2～5 d).194例随访1～60个月,平均24个月,盆腔检查和B超均正常. 结论腹腔镜下卵巢囊肿手术安全有效,具有创伤小、术后恢复快、住院时间短等特点.     

Giant chylolymphatic mesenteric cyst and its successful enucleation: A case report

INTRODUCTION

Cysts of the mesentery are among surgical rarities. The clinical presentation is not characteristic and in addition, the preoperative imaging although suggestive is not diagnostic in this case ultrasound and CTscan was consistent with giant mesenteric cyst. In most cases, the diagnosis is confirmed after surgical exploration.

PRESENTATION OF CASE

A 42 yrs old male patient on exploratory laparotomy had a 14cm×10cm×10 cm cysts which was seen arising from the mesentery ofdistal jejunum 80cm from the duodeno jejunal flexure. The cyst was enucleated successfully from themesentery without entailing resection. The cyst contained milky white fluid consistent with a chylolymphatic cyst. The diagnosis was confirmed on histopathology which revealed a cyst wall with lymphoidaggregates. After 3 years of follow-up, the patient is doing well and there is no evidence of recurrence.

DISCUSSION

The cysts may be asymptomatic or maymanifest with abdominal pain, distension lump or intestinal obstruction. Our patient was symptomatic with mild and long standing abdominal pain. The definitive diagnosis of these lesions is difficult prior to surgical exploration as there are no pathognomonic symptoms or characteristic imaging findings.

CONCLUSION

Cysts of the mesentery are among surgical rarities. In most of the cases the diagnosis is confirmed after surgical exploration and removal of thecyst. We would like to emphasize the importance of successful enucleation of the cyst irrespective of its size due to its independent blood supply as opposed to enterogenous cyst which requires bowel resection and anastomosis.     

Fetal ovarian cysts management and ovarian prognosis: a report of 82 cases

Background/Purpose

Fetal ovarian cysts are frequently complicated by intracystic hemorrhage without associated clinical signs, which is often secondary to ovarian torsion leading to loss of the ovary. The aim of this study was to evaluate ovarian outcome and the place of prenatal management and surgery in the first few days of life in order to save the ovary.

Methods

Between January 1987 and June 2006, 82 fetal ovarian cysts in 79 patients were managed and clinically and ultrasonographically followed up for several months (median, 11 months; range, 6 months to 10 years) in all of the cases where the ovary was not removed. The ultrasonographic results regarding the ovarian parenchyma were broken down into 3 categories: follicular ovary, homogeneous ovary, and undetected ovary.

Results

Twenty-seven cysts remained simple throughout their evolution, and 55 were complicated by intracystic hemorrhage usually several weeks before birth. Overall, after disappearance of the cyst, a follicular ovary was detected in only 39% of the cases (32/82) and more often when the cyst was simple than when it presented an intracystic hemorrhage (85% vs 16.4%, χ², P < .0001).

Conclusions

A review of our series confirms the poor ovarian outcome linked to ultrasonographic signs of intracystic hemorrhage. Preventive action by puncture of “simple” cysts is still being studied. The presence of a bilateral cyst can, if pulmonary maturity has been reached, be an argument for inducement of premature birth with a view to performing conservative surgery. After birth, surgery in the first few days of life is only justified if the signs of intracystic hemorrhage appeared in the period very close to birth.     

腹腔镜下良性卵巢囊肿手术112例临床探讨

目的探讨腹腔镜卵巢囊肿手术的适应证、手术技巧. 方法腹腔镜下行卵巢囊肿剥除术、卵巢囊肿切除术和附件切除术共112例. 结果卵巢囊肿剥除术104例(92.9%),附件切除术5例(4.5%),卵巢/卵巢囊肿切除术3例(2.7%).手术时间(61.9±23.7) min,术中出血(37.0±40.7) ml.术后住院(6.8±2.4) d,术后最高体温(37.8±0.5) ℃,术后体温持续37.5 ℃以上(2.0±1.1) d,肛门排气时间(1.9±0.5)天.术后病理诊断:卵巢巧克力囊肿54例(48.2%)、良性畸胎瘤30例(26.8%)、卵巢冠囊肿16例(14.3%)、黄素囊肿8例(7.1%)、浆液性囊肿3例(2.7%)、纤维瘤1例(0.9%).结论腹腔镜手术治疗良性卵巢囊肿具有微创手术的优点.术前、术中必须严格掌握适应证及准确判断,尽量避免恶性卵巢肿瘤的可能性.     

腹腔镜手术治疗卵巢良性肿瘤110例分析

目的:探讨腹腔镜手术治疗卵巢良性肿瘤的效果。方法:回顾性分析1996年4月至2008年8月我院应用腹腔镜手术治疗110例卵巢良性肿瘤患者的临床资料。结果:92例行腹腔镜下肿瘤切除术,18例行附件切除术。术后96例获随访6~60个月,1例术后1年复发,为同侧卵巢浆液性囊腺瘤;1例术后5年发生双侧卵巢乳突状浆液性囊腺癌;余术后均无复发及腹腔粘液瘤发生。结论:经过严格的术前筛查,腹腔镜手术治疗卵巢良性肿瘤安全、有效,值得推广应用。     

后腹腔镜肾错构瘤剜除术：附15例报告

目的探讨后腹腔镜保留肾单位手术治疗肾错构瘤的方法和疗效。方法2008年5月至2010年11月,实施后腹腔入路腹腔镜肾错构瘤剜除术15例,本组15例,女12例,男3例,年龄19～57岁,平均39岁。肿瘤均位于肾脏的背侧,左侧11例,右侧4例。肿瘤大小3．5～7cm,平均4．6cm。结果15例手术均取得成功,无中转开放。手术时间70～160min,平均110min。出血量40-150ml,平均70ml。术后住院时间4～8d,平均5d。无输血,无尿漏和继发性出血等并发症。14例术后随访2～25个月,1例失访。无肿瘤复发,患肾功能正常。结论后腹腔镜下肾错构瘤剜除术安全可行,是一种值得推广的治疗方法。     

腹腔镜治疗巨大卵巢囊肿19例报告

目的:探讨腹腔镜巨大卵巢囊肿手术的可行性及安全性.方法:回顾分析2008年3月至2010年7月行腹腔镜手术治疗19例直径15～24cm巨大卵巢囊肿患者的临床资料,总结分析其病例选择、手术方式、手术时间、出血量、住院时间、术后并发症等.结果:19例术中冰冻及病理结果均为良性肿瘤,手术均获成功,无一例中转开腹.16例行卵巢...     

腹腔镜手术治疗卵巢良性病变的价值——附1387例分析

目的　探讨腹腔镜手术治疗卵巢良性病变的临床应用价值。　方法　回顾性分析 1995年 1月至 2 0 0 1年 2月卵巢肿瘤 13 87例 ,术前根据患者的年龄、病史、B超和血清CA1 2 5水平排除恶性肿瘤确定为卵巢良性病变者施行腹腔镜手术 ,分析其疗效。　结果　术后诊断卵巢内膜异位囊肿 5 3 1例、卵巢畸胎瘤 2 5 4例、炎性肿块 13 9例、卵巢浆液性囊腺瘤 12 1例、卵巢粘液性囊腺瘤 67例、输卵管系膜囊肿 12 8例、卵巢单纯性囊肿 14 0例、卵巢纤维上皮瘤 3例、粘液性交界性囊腺瘤 1例、粘液性囊腺癌 1例、卵巢子宫内膜样癌 1例、卵巢恶性纤维上皮瘤 1例。术前、术后卵巢良性病变诊断符合率 99 7%。 13 87例除 2例卵巢癌 ,(卵巢子宫内膜样癌及卵巢恶性纤维上皮瘤各 1例 )转开腹切除子宫外 ,其余均在腹腔镜下完成手术。　结论　腹腔镜手术治疗卵巢良性病变具有同开腹手术相同的疗效 ,而且对腹腔干扰小、术后盆腔粘连减少、恢复快、并发症少、住院日短及腹部疤痕小等优点 ,具有临床应用价值     

Treatment of ovarian dermoid cysts

The purpose of this study was to discuss the place and the specific modalities of laparoscopic surgery in the management of ovarian dermoid cysts. This retrospective and noncomparative study was carried out in 65 patients who presented dermoid ovarian cyst between January 1986 and December 1990 in our institution. The surgical treatment was performed purely by laparoscopy in 86.2% of the cases (56 patients). The modalities of laparoscopic surgery were as follows: ovariectomy (8 cases; 14.3%), transparietal cystectomy (4 cases; 7.1%) and intraperitoneal cystectomy (44 cases; 78.6%). In 15 cases (15/44=34%) the intraperitoneal cystectomy was carried out without opening the cyst and the intact cyst was extracted using an endoscopic impermeable sack. We observed no cases of chemical peritonitis. The risk of recurrence after conservative treatment is 4% (two patients) and out of the ten patients for whom a second-look laparoscopy was performed only two (20%) presented adhesions. Laparoscopic treatment of dermoid ovarian cysts is feasible, safe, and effective. The treatment can be conservative in over 80% of the cases. The specific risk of chemical peritonitis can be countered by a change in the cystectomy technique. The use of an impermeable laparoscopic sack permits extraction of the cyst without any peritoneal contamination.