中晚期妊娠合并子宫附件肿物的腹腔镜手术

目的:探讨中晚期妊娠合并子宫附件肿物实施腹腔镜手术的可行性、安全性、影响因素以及优点。方法:为2例中晚期妊娠合并子宫附件肿物患者实施腹腔镜手术,均在全麻下施术。1例为妊娠28周合并反复发作的卵巢囊肿蒂扭转,1例孕18周合并卵巢畸胎瘤。对2例患者术中、术后情况及妊娠结局结合文献进行讨论。结果:2例患者均用腹腔镜成功完成手术。术中、术后无任何并发症发生。妊娠结局良好。结论:有经验的医师为妊娠中晚期合并子宫附件肿物患者实施腹腔镜手术是可行的。手术安全、有效,与传统开腹手术相比,具有住院时间短,术后并发症少,母儿病率少等优点。     

悬吊式免气腹腹腔镜卵巢巨大肿瘤剥除术30例报告

目的:评估悬吊式免气腹腹腔镜卵巢巨大肿瘤剥除术的疗效和可行性.方法:回顾分析2007年1月至2010年10月为30例卵巢巨大肿瘤患者行悬吊式免气腹腹腔镜手术的临床资料.结果:30例均顺利完成手术,术中无脏器损伤及中转开腹.术后无化学性腹膜炎、感染等并发症发生.手术时间60～150min,平均90min,术中出血50～1...     

Laparoscopic management of a nonobstetric emergency in the third trimester of pregnancy

Background Laparoscopic management of nonobstetric acute abdominal pain during pregnancy remains controversial. A gestational age of 26 to 28 weeks has been considered the upper limit for laparoscopy by some authors. A case series of nonobstetric surgery in advanced pregnancy is reported. Methods Third-trimester patients who underwent surgery between 1997 and 2006 were reviewed. Results Laparoscopic surgery was performed for nonobstetric emergencies during the third trimester for 11 patients. Four patients underwent open surgery. The laparoscopic surgery group included five cholecystectomies, four appendectomies, and two adenexal surgeries. The laparoscopic surgery procedure was successfully completed for 10 patients. Of these 10 patients, 9 had no complications and went on to deliver a healthy term infant. One patient went into preterm labor after a laparoscopic appendectomy for perforated acute appendicitis with purulent peritonitis and delivered a viable infant at 34 weeks. Another patient at 29 weeks of gestation underwent a diagnostic laparoscopy for abdominal pain. Adenexal torsion of a large multicystic ovarian mass led to a laparotomy (obstetrician preference) and right salpingo-oophrectomy. Her postoperative course was complicated by an episode of sudden syncope, hypotension, and fetal distress on postoperative day 3. An emergent laparotomy showed hemoperitoneum attributable to bleeding from the ovarian pedicle. A cesarean section delivery of a preterm infant requiring neonatal resuscitation was performed. The open surgery group included four patients. Two of the patients underwent appendectomies at 35 and 33 weeks, respectively, followed by a term delivery. The remaining two patients underwent emergent colectomies with a cesarean section delivery at 31 and 38 weeks, respectively. Conclusions This study demonstrated that laparoscopic surgery in the third trimester of pregnancy is feasible and can be performed safely with an acceptable risk to the fetus and the mother. Access to the pregnant abdomen is easily obtained. Space generally is not a problem, and there is minimal uterine manipulation. Paper presented at the Scientific Session of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), Dallas, Texas, USA, April 2006     

Safety and efficacy of laparoscopic surgery in pregnancy: experience of a single institution

We report all the procedures performed in pregnant patients in our institute. There were 2 cases of laparoscopic mesh repair (for posterolateral diaphragmatic Bochdalek hernia and laparoscopic Heller cardiomyotomy) and 1 laparoscopic cystectomy for torsion of an ovarian cyst; 7 laparoscopic appendectomies (6 for acute appendicitis and 1 for perforated appendix); and 9 laparoscopic cholecystectomies (8 for acute cholecystitis and 1 for gallbladder empyema). All these patients were in their second trimester of pregnancy. All the laparoscopic procedures were successful: there was no mortality, morbidity, or conversions. There were no complications for either mother or child related to general anesthesia. The changes in physiology of the pregnant patient have to be adequately addressed and proper precautions taken to ensure safety. The second trimester is the ideal time to do laparoscopic surgery, though procedures have been performed in all trimesters. Our initial experience is satisfactory, although more data are essential to standardize laparoscopic procedures in pregnancy. We conclude that laparoscopic surgery is proving to be as safe as open surgery in pregnancy.     

Management of benign ovarian cysts by a novel, gasless, single-incision laparoscopic technique: keyless abdominal rope-lifting surgery (KARS)

Background

To find the most efficacious method to minimize the side effects and maximize the advantages of laparoscopic surgery, this study aimed to define and document a gasless, single-incision abdominal access technique for the management of benign ovarian cysts.

Methods

During a 1½ year period, 55 women underwent surgery for a benign ovarian cyst. Conventional carbon dioxide (CO₂) laparoscopy was used for 33 of the women, and 22 of the women underwent a novel, gasless, single-incision laparoscopic surgery. An abdominal access pathway through a single intraabdominal incision was used to place transabdominal sutures that elevated the abdominal wall, and the operations were performed through the intra-umbilical entry without the use of trocars. Thus, the new technique was called keyless abdominal rope-lifting surgery (KARS). Two operative groups were compared to assess the feasibility of the new technique.

Results

All the operations could be performed by KARS without conversion to CO₂ laparoscopy or laparotomy. However, for two patients in the conventional laparoscopy group, minilaparotomy had to be performed for tissue retrieval. Although the two techniques had many similar results, the total operative times and the abdominal access times in the KARS group were significantly longer than in the conventional laparoscopy group (p < 0.05). Simple oral analgesics were adequate for postoperative pain relief in both groups.

Conclusions

The KARS technique is a gasless, single-incision laparoscopic procedure that can be performed safely and effectively in terms of cosmesis, postoperative pain, and fertility preservation for the management of benign adnexal pathologies.     

腹腔镜与开腹手术治疗中期妊娠卵巢肿瘤的比较

目的探讨腹腔镜手术治疗中期妊娠卵巢肿瘤的可行性和安全性。方法2006年1月～2011年1月我院32例中期妊娠合并卵巢肿瘤分别行全麻下腹腔镜手术（腹腔镜组,n=14）和开腹手术（开腹组,n=18）。腹腔镜手术一般距离宫底或肿瘤上缘（以大者为准）至少3横指处做第一切口,余切口随之改变,气腹形成后,监测生命体征及氧饱和度直至手术结束后1h。卵巢肿瘤剥除术：用剪刀切开肿瘤包膜,将肿瘤完整剥出装袋取出,若肿瘤直径〉8cm,穿刺抽吸囊液后剥除肿瘤。患侧附件切除术：提起附件边凝边切,取出同卵巢肿瘤剥除术。结果腹腔镜组肿瘤剥除术10例,附件切除术4例,无一例中转开腹。开腹组肿瘤剥除术13例,附件切除术5例。腹腔镜组手术时间（73．9±26．8）min与开腹组（72．8±22．2）min比较无统计学差异（t=0．127,P=0．900）。腹腔镜组术中出血量（56．4±25．9）ml与开腹组（48．9±22．5）ml比较无统计学差异（t=0．876,P=0．388）。腹腔镜术后住院（5．0±0．8）d,显著短于开腹组（8．7±2．8）d（t=-4．779,P=0．000）。术后病理：腹腔镜组成熟性畸胎瘤12例,黏液性囊腺瘤2例;开腹组成熟性畸胎瘤5例,黏液性囊腺瘤10例,浆液黏液混合性囊腺瘤2例,交界性乳头状囊腺瘤1例。卵巢肿瘤蒂扭转9例,其中成熟性畸胎瘤8例,黏液性囊腺瘤（伴囊壁钙化）1例。患者术后均无并发症,随访至分娩,腹腔镜组新生儿Apgar评分（9．8±0．4）分与开腹组（9．7±0．5）分比较无统计学差异（t=0．584,P=0．564）;新生儿出生体重（3357．7±471．2）g与开腹组（3421．9±155．9）g比较无统计学差异（t=-0．513,P=0．612）;新生儿出生孕周（38．5±1．3）周与开腹组（39．1±0．9）周比较无统计学差异（t=-1．466,P=0．154）;早产率与开腹组无统计学差异[7．7％（1／13） vs．0,P=0．448]。结论腹腔镜手术治疗中期妊娠卵巢肿瘤是安全可行的。     

Laparoscopic excision of a mesenteric cyst during pregnancy.

BACKGROUND: Laparoscopic management of mesenteric cysts during pregnancy has not been reported before. CASE REPORT: A young woman with a mesenteric cyst associated with a crossed ectopic kidney, underwent laparoscopic excision of the cyst in the second trimester of pregnancy. The procedure was completed without complications, and the patient was discharged on the third postoperative day. Thereafter, the pregnancy progressed uneventfully, and she delivered a healthy baby at term. CONCLUSION: Laparoscopic management of mesenteric cysts during pregnancy is feasible, safe, and less invasive than laparotomy when performed in select patients by experienced surgeons.     

Non-Gynecologic Laparoscopy in Second and Third Trimester Pregnancy: Obstetric Implications

Purpose:

To review the effect of non-gynecologic laparoscopic procedures performed during the second and third trimesters of pregnancy on pregnancy outcome.

Materials and Methods:

A review of the patient log for the antenatal obstetrical unit was used to identify the patients in this series from January 1, 1997 to December 31, 1997. Medical records were then analyzed to identify estimated gestational age at surgery and delivery, type of delivery, use of tocolysis, and complications from surgery.

Results:

Nine patients were identified as having non-gynecologic laparoscopic surgery (without conversion to laparotomy) during the second or third trimester of pregnancy. The median estimated gestational age at surgery was 25 weeks (mean 24 weeks). The most common procedure performed was laparoscopic cholecystectomy (6 patients). Five patients received tocolysis after the initial procedure. All patients delivered at greater than or equal to 37 weeks estimated gestational age (median 38 weeks). No infants were admitted to the neonatal intensive care unit.

Conclusions:

Laparoscopic procedures appear safe in second and third trimester pregnancy. In this study, laparoscopic cholecystectomies were performed as late as 34 weeks estimated gestational age without any adverse effects on pregnancy outcome.     

Management of an ovarian cyst during pregnancy

OBJECTIVE: With routine ultrasonographic examination during the first trimester, the discovery of an ovarian cyst has become relatively common in the beginning of pregnancy. Between a waiting policy and interventionism, where is the optimal management situated? The objective of this article, based on the analysis of articles published on the subject in the data base of Medline, was to reply to this question. IN GENERAL: Most of unilocular and anechoic ovarian cysts with thin borders during the first trimester are corpus luteum cysts. They are not generally present after the end of the first trimester. Except in the case of complications, abstention is advocated in their respect. After 16 weeks of amenorrhea, organic cysts are the most frequent, mainly dermoid cysts. Only ovarian cysts at risk of complication are to be considered. They are essentially ovarian cysts which, whatever their echogenic features, have a size > or =6 cm. Their prevalence is estimated between 0.5 and 2 per thousand of pregnancies. The complications of these cysts are represented mainly by torsion, intracystic bleeding and rupture. THE TIME FOR SURGERY: Emergency surgery during the first trimester, especially before 9th week of amenorrhea, for complication of an ovarian cyst is associated with a high rate of abortion. In the second part of pregnancy, foetal morbidity with prematurity provoked by emergency surgery is considerable. The ideal period for scheduled surgery is probably the beginning of the second trimester. The probability of operating on a functional cyst becomes small and the rate of abortion is minimized. Coelioscopy is then often possible and does not appear to have much impact on the pregnancy. If we are sure of the organic character of an ovarian cyst, after 9 weeks of amenorrhea, then surgery is recommended.     

Laparoscopic extracorporeal oophorectomy and ovarian cystectomy in second trimester pregnant obese patients.

OBJECTIVES: To determine whether a modified technique for laparoscopic extracorporal oophorectomy is less complicated and safer than traditional laparoscopic oophorectomy. METHODS: Four obese patients in their second trimester underwent open laparoscopy for treatment of large ovarian cysts. A Cook Ob/Gyn special cyst aspirator with a 14-gauge aspirating needle was inserted into the abdomen to drain the ovary through a separate 10-mm port; the site of insertion depends on the location of the ovary. After the cyst was decompressed, the 10-mm incision was enlarged to 3 cm, and either extracorporal oophorectomy or cystectomy was performed. RESULTS: No complications occurred. Average blood loss was less than 15 cc; average carbon dioxide insufflation time was less than 20 minutes. Average operating time was 40 minutes, which was significantly less than traditional laparoscopic oophorectomy. The patients were discharged in less than 23 hours. Patient A had a 500-cc dermoid cyst, and subsequently had a normal vaginal delivery at term. Patient B had a 1600-cc cyst removed. She had a cesarian delivery due to cephalopelvic disproportion. Pathological analysis of the specimen identified the mass as a dermoid cyst and serous cystadenoma. Patient C had a 3200-cc ovarian cyst. Currently, she is in her 24th week of gestation. Patient D had a 700-cc simple ovarian cyst removed at her 16th week of gestation. CONCLUSIONS: Laparoscopic extracorporal oophorectomy requires significantly less CO2 insufflation time and a shorter operation time, hence, decreasing the adverse effects on the fetus. The enlarged second trimester uterus made traditional laparoscopy more complicated. Performing the procedure extracorporally decreased the possibility of operative complications.     

Laparoscopic surgery during the second trimester of pregnancy: indications, technique, and fetal repercussions. Report of nine cases and review the literature]

Non-obstetric abdominopelvic surgery during pregnancy is associated with a considerable materno-foetal complication rate related to the delayed diagnostic and therapeutic management and the severity of the underlying disease. Based on retrospective analysis of 9 laparoscopies performed during the second trimester of pregnancy between the months of January 1994 and October 1996 in the Gynaecology and Obstetrics Department of Hospital Bichat, the authors study the feasibility of this technique. They report 9 cases of abdominopelvic disease, in which laparoscopy allowed a diagnostic and therapeutic approach: 6 cases of adnexal disease, 2 appendicular syndromes and one diagnostic laparoscopy. The maternal and obstetric course was favourable in each case. Several cases of laparoscopic appendicectomy, cholecystectomy, and adnexal surgery during pregnancy have been published since 1990. The main reasons theoretically contraindicating laparoscopy after the first trimester of pregnancy are the risk of uterine injury and the foetal risk during creation of the pneumoperitoneum. Experimental data are limited, but the increased intra-abdominal pressure and the use of CO2 do not appear to have any harmful effects in animals (foetal lambs). By respecting a certain number of technical precautions, laparoscopy during the second trimester of pregnancy can constitute a legitimate diagnostic and therapeutic approach.     

Laparoscopic management of appendicitis and symptomatic cholelithiasis during pregnancy

Background Laparoscopic surgery during pregnancy is a challenging procedure that most surgeons are reluctant to perform. The objective of this study was to evaluate whether laparoscopic appendectomy and cholecystectomy is safe in pregnant women. The management of these situations remains controversial. We report a single center study describing the successful management of 16 patients during pregnancy.Methods More than 3,356 laparoscopic procedures were performed in our institutions between May 1990 and June 2005. Sixteen of these patients were operated on in the second and third trimester between 22 and 32 weeks of estimated gestational age. We performed 11 laparoscopic appendectomies and 5 laparoscopic cholecystectomies. We also reviewed the management and operative technique used in these patients.Results In this study, the laparoscopic appendectomy or cholecystectomy was performed successfully in all patients. Three patients were in their second trimester, weeks 22, 23, and 25, and 13 were in the third trimester, weeks 27 (three patients), 28 (five patients), 31 (three patients), and 32 (two patients). No maternal or fetal morbidity occurred. Open laparoscopy was performed safely in all patients and all patients delivered healthy babies.Conclusion From our experience laparoscopic management of appendicitis and biliary colic during pregnancy is safe, however the second trimester is preferable for laparoscopic cholecystectomy. Pregnancy is not a contraindication to the laparoscopic approach to appendicitis or symptomatic cholelithiasis. We believe that laparoscopic operations, when performed by experienced surgeons, are safe and even preferable for the mother and the fetus.     

妊娠早期腹腔镜手术14例临床分析

目的探讨早期妊娠腹腔镜手术经验及在妊娠早期急腹症中的使用价值。方法对我院2001年12月至2009年6月期间的14例早期妊娠时腹腔镜手术进行回顾性分析。结果 14例患者中,无一例死亡,3例孕早期宫内宫外同时妊娠患者术后自然流产,10例足月剖宫产分娩,1例现继续妊娠32周。新生儿出生体重2,600～3,650 g,平均(3,224.1±323.1)g。新生儿出生后1 minApgar评分7例10分、3例9分,未见畸形。结论只需掌握手术指征及操作技巧,腹腔镜手术可以作为早期妊娠时急腹症首选的有效治疗方法。     

非气腹腹腔镜手术治疗妊娠合并卵巢良性肿瘤45例

目的：探讨非气腹腹腔镜手术治疗妊娠合并卵巢良性肿瘤的可行性。方法2006年1月～2013年6月对45例妊娠合并卵巢良性肿瘤行非气腹腹腔镜手术,硬膜外阻滞麻醉下按照非气腹腹腔镜手术常规操作,一般行肿瘤剥除术,肿瘤巨大、缺乏或剩余极少正常卵巢组织或已扭转坏死行患侧附件切除术。结果45例均顺利完成非气腹腹腔镜手术,无中转开腹和并发症发生。42例行卵巢肿瘤剥除术,3例行患侧附件切除术。手术时间25～90 min,（40．7±14．9） min;术中出血量10～80 ml,（27．3±16．6）ml;住院时间3～8 d,（4．5±1．3）d。术前、术中、术后动脉血pH值、二氧化碳分压（blood pressure carbon dioxide, PaCO2）、氧分压（blood oxygen partial pressure,PaO2）均无统计学差异（F＝0．00,P＝0．999;F＝2．21, P＝0．114;F＝0．60,P＝0．555）,碳酸氢根（bicarbonate,HCO3-）和血氧饱和度（blood oxygen saturation,SpO2）虽有统计学差异（F＝14．96,P＝0．000;F＝9．45,P＝0．000）,但无临床意义,均在正常范围内。术前、术中、术后监测胎心率均在正常范围内。术前、术中、术后心率和血压比较无统计学差异（P＞0．05）。术后病理：成熟性囊性畸胎瘤25例（55．6％）,浆液性囊腺瘤6例（13．3％）,黏液性囊腺瘤4例（8．9％）,输卵管系膜囊肿3例（6．7％）,子宫内膜异位囊肿2例（4．4％）,黄体囊肿5例（11．1％）。术后随访无自然流产,43例妊娠至足月分娩,新生儿出生体重和Apgar评分未见异常,2例术后要求放弃胎儿。结论非气腹腹腔镜手术治疗妊娠合并卵巢良性肿瘤期是安全可行的。     

Appendectomy during the third trimester of pregnancy in a 27-year old patient: case report of a "near miss" complication

The management of acute appendicitis during pregnancy is not fully established, especially regarding the choice between open and laparoscopic surgery during the third trimester. We report herein the case of a major uterine variecele hemorrhage during a laparoscopic appendectomy in a 27-year old pregnant patient at 33 weeks of amenorrhea. After conversion to a Pfannenstiel incision, the baby was delivered, the bleeding stopped and the appendectomy completed. While both mother and child fully recovered, this ?near miss? complication underlines the challenges linked to the management of acute appendicitis during pregnancy. Based on a literature review, we propose an algorithm favoring the laparoscopic approach during the first and second trimesters, and the open approach during the third trimester (especially after the 26th week of amenorrhea). In case of unclear pre-operative diagnosis, a laparoscopy should be conducted even during the third trimester with a Mc Burney conversion when the diagnosis of appendicitis is confirmed.     

Laparoscopic excision of a giant ovarian cyst after ultrasound-guided drainage

The laparoscopic approach to giant ovarian cysts in pediatric population may be difficult regarding the risk of cyst rupture and limited working space. We herein report a 16-year-old adolescent girl that presented with a giant ovarian cyst. To reduce the limitations of the laparoscopy, we performed laparoscopy after draining the cyst under ultrasonographic guidance. Under local anesthesia, a nephrostomy catheter was placed into the cyst by the Seldinger technique. During laparoscopy, abdominal cavity was explored by the scope and then the nephrostomy catheter was removed. Laparoscopic procedure was completed easily. No pre- and postoperative complications were encountered and the patient was discharged on the second postoperative day. The pathologic examination of the cyst revealed as follicular cyst.Laparoscopic excision of giant ovarian cysts after ultrasound-guided drainage seems to be safe and applicable treatment modality in children.     

Laparoscopic surgery for symptomatic cholelithiasis during pregnancy

INTRODUCTION: We are introducing here additional evidence regarding efficacy and safety of laparoscopic cholecystectomy during pregnancy. This is achieved by analysis of 10 successful cases of symptomatic cholelithiasis operated laparoscopically during pregnancy. PURPOSE: To prove the fact that laparoscopic cholecystectomy is safe and effective during pregnancy, especially in the first trimester. BACKGROUND: Cholecystectomy represents the second most common nonobstetric operation during pregnancy. The laparoscopic management of symptomatic cholelithiasis during pregnancy is becoming the standard of care at our center king Abdullah university hospital (KAUH). Old restrictions on this treatment modality are changing; open surgery is not considered to be the only choice any more. METHODS: Ten laparoscopic cholecystectomies during pregnancy at variable gestational ages performed between February 2002 and June 2006 are reported here, all at KAUH. Their medical records were reviewed, deliveries were followed up, outcomes were analyzed, and results were compared with literature. RESULTS: Five patients were in their first trimester; 3 were in their second trimester and 2 in their third trimester in my series. Open cholecystectomy was not used at all in these patients. Intraoperative cholangiography was not performed. No tocolytic agents were given. No maternal or fetal mortality have been reported. None of fetuses had anomalies. One patient who refused any surgical intervention presented with repeated attacks of biliary colic at gestational age of 26 weeks; this pregnancy ended up with stillbirth at 33 weeks. CONCLUSIONS: In my series, laparoscopic cholecystectomy was safe through out all stages of pregnancy. When undertaken by skilled laparoscopic surgeon, it carries low mortality and morbidity. We highlight the fact that first trimester symptomatic cholelithiasis can be managed safely by laparoscope. We add to the evidence that laparoscopic cholecystectomy may not interfere with organogenesis. Early uterine contractions were not reported, though, we think that prophylactic tocolytics are not indicated unless uterine contractions are confirmed. Certain positioning styles, and cannulation techniques, are part of major guidelines that we recommend to be followed during this surgery.     

Laparoscopic appendectomy during pregnancy

Appendectomy is the most common nonobstetric operation during pregnancy, but laparoscopy has not been considered to be the preferred procedure until recently. The objective of this study was to report the authors' experience with laparoscopic appendectomy during pregnancy and to review the available literature. Six patients underwent laparoscopic appendectomy during pregnancy, and 24 additional cases from the literature were reviewed. Two patients underwent surgery during the first trimester of pregnancy, three patients underwent surgery during the second trimester, and one patient underwent surgery during the third trimester. The Hasson open technique was used in five cases, and the Veress needle was used in one case. Port site locations were adapted to the size of the gravid uterus. Three patients had histologically confirmed appendicitis and underwent delivery of a neonate after 36 weeks (n = 1) and 37 weeks (n = 2) of gestation. Two patients had uterine infections and underwent abortions 2 days after surgery and 6 weeks after surgery, respectively. One patient had an isolated torsion of the right fallopian tube that was diagnosed using laparoscopy. These results show that laparoscopic appendectomy can be safely performed during pregnancy. One limitation may be the size of the gravid uterus, which interferes with adequate visualization and instrumentation in the third trimester of pregnancy.     

Laparoscopic removal of a gastric trichobezoar in a pregnant woman

We describe the laparoscopic removal of a gastric trichobezoar performed on an 18-year-old woman in her second trimester of pregnancy. The laparoscopic removal of a gastric trichobezoar has not previously been described in an adult. Laparoscopy during pregnancy is never without the fear of harm including spontaneous abortion of the developing fetus, however, increasing cumulative worldwide experience suggests that there is no significant difference in fetal morbidity with laparoscopy when compared with laparotomy. A review of laparoscopy in pregnancy with regard to this case is presented.     

自制入路通道单孔腹腔镜手术治疗妊娠期巨大良性卵巢囊肿的临床分析

目的探讨自制入路通道(port)单孔腹腔镜手术治疗妊娠期巨大良性卵巢囊肿的可行性和安全性。 方法收集2016年3月至2019年3月在青岛妇女儿童医院进行自制入路通道单孔腹腔镜下妊娠期巨大良性卵巢囊肿剥除术的11例患者(其中10例为早孕期、1例为中孕期)的临床资料,对手术时间、术中出血量、术后住院时间、围术期并发症、术后1 d疼痛VAS(Visual Analogue Scale/Score)评分、后续妊娠情况及有无复发等指标进行回顾性分析。 结果11例患者均顺利完成手术,术中无囊肿破裂或囊肿内容物流入腹腔,无患者中转开腹或多孔腹腔镜手术,中位手术时间55(30～120)min,中位术中出血量10(5～50)ml,术后1 d疼痛VAS评分平均1.5分。术后1例出现先兆流产,给予保胎治疗后继续妊娠,无其他术中、术后并发症发生;9例患者术后足月顺利分娩,2例患者顺利妊娠,所有患者术后均未复发。 结论自制入路通道单孔腹腔镜手术治疗妊娠期巨大良性卵巢囊肿安全、有效、经济,不良反应较少,值得临床推广应用。