Nowak M, Szpakowski M, Malinowski A, Maciołek-Blewniewska G, Wilczyński J R, Władziński J, Kamiński T, Raczkowska Z
Kliniki Chirurgii Ginekologicznej Instytutu Centrum Zdrowia Matki Polki w Lodzi.
Ginekol Pol. 2000 Sep;71(9):1173-8.
The purpose of our study was to compare operative procedures, histologic types of tumours, and intra- and postoperative complications of patients operated for benign ovarian cysts by laparotomy or laparoscopy.
257 patients with different types of ovarian cysts underwent operations by laparoscopy (51 cases) or laparotomy (206 cases). Careful selection for operative treatment was made on the basis of clinical findings, ultrasound scans (using colour Doppler), patient's age and history. Operative laparoscopies were performed in patients with "unsuspected" ovarian cysts with diameter < or = 8 cm. During every operation, a histologic examination of tumour was performed.
In 42 patients the cysts were found in both ovaries. Remaining 215 women had unilateral ovarian tumours. Adnexectomy was carried out in 142 cases, cystectomy in 131, ovariectomy in 18, and aspiration and electrocoagulation of ovarian cysts in 8 cases. The most common laparoscopic procedures were cystectomy (41) and aspiration and electrocoagulation of ovarian cysts (8); while by laparotomy: adnexectomy (142) and cystectomy (131); p < 0.0001. The histopathological assessment showed as follows: serous cysts in 98 cases, dermoid cysts in 75, endometrial cysts in 63, mucous cyst in 23, and others (mainly haemorrhagic, functional cysts and fibrothecomas) in 40 cases. The incidence of operative complications (3/257--all due to insufficient hemostasis) and postoperative complications (infection--7/257, anaemia--4/257, peritonitis--1/257) was rather low and similar in patients operated by laparoscopy and laparotomy. Patients were generally discharged from the hospital on the fourth (median) postoperative day after laparoscopies and the seventh (median) day after laparotomies (p < 0.0005).
Operative treatment of ovarian benign cysts is connected with a very low risk for intra- and postoperative complications. The operative laparoscopy brings better cosmetic effects and seems to be safe and effective method of treatment of ovarian benign cysts.
我们研究的目的是比较经剖腹手术或腹腔镜手术治疗良性卵巢囊肿患者的手术方式、肿瘤组织学类型以及术中及术后并发症。
257例不同类型卵巢囊肿患者接受了腹腔镜手术（51例）或剖腹手术（206例）。根据临床检查结果、超声扫描（使用彩色多普勒）、患者年龄和病史进行仔细的手术治疗选择。对直径≤8cm的“未怀疑”卵巢囊肿患者进行腹腔镜手术。每次手术期间，均对肿瘤进行组织学检查。
42例患者双侧卵巢均发现囊肿。其余215例女性为单侧卵巢肿瘤。142例行附件切除术，131例行囊肿切除术，18例行卵巢切除术，8例行卵巢囊肿抽吸及电凝术。最常见的腹腔镜手术方式为囊肿切除术（41例）和卵巢囊肿抽吸及电凝术（8例）；而剖腹手术方式为：附件切除术（142例）和囊肿切除术（131例）；p<0.0001。组织病理学评估结果如下：浆液性囊肿98例，皮样囊肿75例，子宫内膜囊肿63例，黏液囊肿23例，其他（主要为出血性、功能性囊肿及纤维卵泡膜瘤）40例。手术并发症发生率（257例中有3例，均因止血不充分）和术后并发症发生率（感染——257例中有7例，贫血——257例中有4例，腹膜炎——257例中有1例）相当低，且腹腔镜手术和剖腹手术患者相似。腹腔镜手术后患者一般在术后第4天（中位数）出院，剖腹手术后在第7天（中位数）出院（p<0.0005）。
卵巢良性囊肿的手术治疗术中及术后并发症风险极低。腹腔镜手术具有更好的美容效果，似乎是治疗卵巢良性囊肿安全有效的方法。
