Parker W H
Department of Obstetrics and Gynecology, University of California-Los Angeles School of Medicine.
J Reprod Med. 1992 Jul;37(7):603-6.
The management of adnexal masses by operative laparoscopy is controversial. The application of strict criteria for preoperative patient selection and careful intraoperative assessment and management are critical to the appropriate use of this approach. Clinical examination, ultrasound imaging of the pelvis and the addition of the CA-125 tumor marker in postmenopausal women can aid in the selection of a population at low risk for malignancy that may be appropriate for operative laparoscopic adnexal surgery. Recommended procedures include careful intraoperative inspection of the pelvis and abdomen, liberal use of frozen sections, and conversion to immediate-staging laparotomy when malignancy is found.
通过手术腹腔镜检查处理附件包块存在争议。术前严格的患者选择标准以及仔细的术中评估和处理对于合理应用这种方法至关重要。临床检查、盆腔超声成像以及在绝经后女性中加用CA - 125肿瘤标志物有助于选择可能适合手术腹腔镜附件手术的低恶性风险人群。推荐的操作包括术中仔细检查盆腔和腹部、广泛使用冰冻切片，以及发现恶性肿瘤时立即转为分期剖腹手术。
