经腹腔镜手术(体外法)切除卵巢良性畸胎瘤

目的　探讨腹腔镜手术 (体外法 )处理卵巢良性畸胎瘤的手术要点及临床应用价值。方法　 2 0 0 0年 3月～ 2 0 0 2年 6月对 2 7例卵巢良性畸胎瘤患者行腹腔镜体外法手术。镜下穿刺吸出囊液 ,固定囊肿并牵引出体外 ,再行囊壁分离重建卵巢后送回腹腔。肿物大小 2 .0～ 9.5cm ,双侧卵巢病变者 3例 ,既往有下腹部手术史者 5例。同时期腹腔镜体内法手术患者 13例为对照组。结果　 2 7例患者腹腔镜体外法手术均获成功 ,平均手术时间 70min ,与对照组 (平均手术时间 99min)比较差异极显著 (P <0 .0 0 1) ;体外法术后盆腔积液量明显少于体内法 (P <0 .0 5 .)。术后平均住院 4 .5d ,全部病人经随访 1年 ,无不适主诉 ,术后无复发。结论　腹腔镜体外法行良性卵巢畸胎瘤剥除手术是一种安全、省时、有效的手术方法。

Laparoscopic (extra-abdominal) ovary benign teratoma resection

Objective:To discuss the main points and the clinical applied value of laparoscopic(extra-abdominal) ovary benign teratoma resection.Methods: To treat the 27 patients suffering from ovary benign teratoma by laparoscopic(extra-abdominal) resection. Puncture the cyst and suck out the hydatid fluid under laparoscope,then fix the cyst and tract it outside the abdominal wall. To separate the cyst wall,and reconstruct the ovary,looking steadily at the cyst. After that,put the ovary back to the abdominal cavity. The sizes of the cysts are between 2 to 9. 5 centimeter,3 patients are suffering from bilateral ovary teratoma,and 5 patients have accept lower abdomen operation before. Make the 13 patients that are treated by laparoscopic (intra-abdominal) ovary benign teratoma resection as control.Results: All the 27 laparoscopic (extra-abdominal) resection are succeed,the mean operation interval is 70 min,comparing to the control(mean operation interval 99 min),there is very significant difference ( P <0. 001). The amount of pelvic hydrocele after extra-abdominal operation is obviously less than intra-abdominal operation( P <0. 05). The mean length of stay after operation is 4. 5 day. During one year of follow-up,there is no discomfort and recur. Conclusions:Laparoscopic (extra-abdominal) ovary benign teratoma resection is a safety,time-saving and effective operation.