卵巢肿瘤的腹腔镜诊断与手术治疗

目的： 评价腹腔镜技术对卵巢肿瘤诊治的价值，探讨在腹腔镜下治疗卵巢肿瘤的病例选择及对交界性卵巢肿瘤、卵巢癌早期治疗的争议问题，并提出对腹腔镜下手术的一些体会。方法：通过收集中山一院１９９４ 年９ 月至１９９９ 年３ 月临床拟诊为良性卵巢肿瘤行腹腔镜手术治疗的１２４ 例病例，来分析腹腔镜技术对卵巢肿瘤诊治的价值。结果：拟诊的１２４ 例卵巢肿瘤中，６ 个为正常盆腔，２ 个子宫肌瘤，１ 例多囊卵巢。１１５ 例卵巢肿瘤的病人有１１０ 例行腹腔镜下手术。腹腔镜下手术的平均时间为６７．３９ ｍｉｎ。术后平均住院时间４．０８ ｄ。仅有３ 例出现术后并发症，１ 例腹膜后血肿；１ 例全身皮下气肿；１ 例伤口感染。结论： 腹腔镜下诊断及治疗卵巢肿瘤有一定的临床价值，而且与剖腹手术相比，较为方便，病人痛苦少；合并较严重的盆腔粘连一般不选择腹腔镜下手术；交界性卵巢肿瘤及卵巢癌的早期采用腹腔镜下治疗仍有争议。目前我们均选取无恶性可疑的卵巢肿瘤行镜下手术治疗。

Laparoscopic Diagnosis and Surgery of Ovarian Mass

Objective: To evaluate the value of laparoscopic diagnosis and surgery for ovarian mass, discuss the selection of cases for laparoscopic surgery, discuss the laparoscopic surgery of borderline ovarian tumor and early ovarian cancer. Methods: 124 patients who were suspected to have benign ovarian masses were evaluated by laparoscopy between September 1994 to March 1999.Results: 124 cases of suspected ovarian diagnosed by laparoscopy, there were 6 of normal pelvic, 2 of myoma, 1 of polycystic ovarian. Among 115 ovarian masses, 110 were treated surgically under laparoscopy. The average time of laparoscopic surgery was 67 39 minutes. The average time of hospitalization after laparoscopy was 4 08 days. Only 3 cases experienced complication. The complications were retroperitoneal hematoma, subcutaneous emphysema and wound infection. Conclusions: Laparoscopic diagnosis and surgery of ovarian masses are valuable in clinical practice. Compared to laparotomy, it is easier to carry out and less pain for patients. Generally, in cases complicated with extensive adhesion were not selected for laparoscopic operation. Laparoscopic surgery of borderline ovarian tumor and early ovarian cancer is still controversial. At present we select cases suspected of non malignant masses for laparoscopic surgery.