腹腔镜下卵巢成熟畸胎瘤剔除手术体会

目的：探讨卵巢成熟畸胎瘤腹腔镜下剔除术的手术技巧。方法：2006年2月～2008年10月我院行卵巢成熟畸胎瘤腹腔镜下剔除术80例，术中将20cm×15cm纱垫一块平放于患侧卵巢下方，用单极电凝在卵巢表面稍薄处点切开长约1cm切口，用分离钳沿切口撕开包膜，轻轻分离包膜与瘤体。如发生瘤体破裂，立即吸除溢出囊外的脂肪。结果：80例患者手术均在腹腔镜下完成，无1例中转开腹，手术时间35—110min，平均63min，剔除肿瘤直径3～10cm。术中瘤体破裂10例，取出瘤体后盆腔冲洗液中14例发现了少量油滴，无毛发及块状脂肪。60例随访患者未出现术后月经紊乱，术后3个月超声检查卵巢结构正常。结论：术中轻柔操作，放置纱垫保护切口周围，切下的成熟畸胎瘤装入标本袋中，可减少肿瘤内容物对腹腔的污染。

Experiences of laparoscopic removal of ovarian mature teratoma

Objective:To investigate the skills of laparoscopic removal of ovarian mature teratoma. Methods:Clinical data of 80 patients undergoing laparoscopic removal of ovarian mature teratoma from February 2006 to October 2008 were studied retrospectively. During the operation,a piece of 20cm×15cm gauze pad was placed in the bottom of the ovary with mature teratoma,then incised 1cm on the thinner place of the surface of the ovary with mature teratoma using unipolar electrocoagulation,and torn the capsule of teratoma along the incision with clamp and separated gently it from the ovary. Fat and other substances overflowed from some ruptured teratoma were sucked out immediately. Resluts:All patients were successfully undergoing laparoscopic removal of tumors,the average operative time was 63 min (35 ~ 110min),the diameters of the removed tumors were 3 ~ 10cm. Ten cases occurred rupture of the teratoma during the operation; oil droplets were found in the pelvic washing fluid of 12 cases after the removal of teratoma,no hair and fatty tissue were found. No menstrual disorders occurred according to postoperative followed-up of 60 cases; the ovarian structure was normal according to ultrasound examination in 3 months. Conclusion:Careful and gental performance,completely protection of the incision with dress,and prevention of tumor rupture and leakage of tumor contents may reduce abdominal contamination.