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妊娠期附件包块腹腔镜手术 10 年经验。

A 10-year experience of laparoscopic surgery for adnexal masses during pregnancy.

机构信息

Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.

出版信息

Int J Gynaecol Obstet. 2011 Apr;113(1):36-9. doi: 10.1016/j.ijgo.2010.10.020. Epub 2011 Jan 17.

Abstract

OBJECTIVE

To assess the clinicopathologic outcomes of laparoscopic surgery for adnexal masses during pregnancy.

METHODS

In a retrospective study, the medical records of 88 patients who underwent laparoscopic surgery for adnexal masses during pregnancy between 2000 and 2009 were reviewed.

RESULTS

The mean age of the study population was 30.1 years (range 21-40 years), and the mean gestational age at surgery was 11.6 weeks (4.6-23.6 weeks). The mean diameter of the mass on sonography was 7.5 cm (1.8-18 cm). Pathologically, the most common tumor was a mature cystic teratoma (35.2%), and the prevalence of malignancy was 6.8%. Emergency surgery due to torsion was performed in 28 patients (31.8%). Two spontaneous abortions occurred, both after emergency surgery. The frequency of obstetric complications, such as low birth weight, preterm delivery, use of tocolytics for preterm labor, low Apgar score, and fetal anomaly, was acceptable.

CONCLUSION

Laparoscopic surgery for adnexal masses during pregnancy provided tolerable outcomes for the fetus and the mother. In the future, larger prospective clinical trials are necessary to elucidate fully the impact on the fetus.

摘要

目的

评估妊娠期间附件肿块行腹腔镜手术的临床病理结局。

方法

在一项回顾性研究中,对 2000 年至 2009 年间行腹腔镜手术治疗妊娠期间附件肿块的 88 例患者的病历进行了回顾。

结果

研究人群的平均年龄为 30.1 岁(范围 21-40 岁),手术时的平均孕龄为 11.6 周(4.6-23.6 周)。超声检查时肿块的平均直径为 7.5cm(1.8-18cm)。病理上,最常见的肿瘤是成熟囊性畸胎瘤(35.2%),恶性肿瘤的患病率为 6.8%。因扭转而行急症手术的患者有 28 例(31.8%)。发生了 2 例自然流产,均发生在急症手术后。低出生体重儿、早产、早产使用宫缩抑制剂、低 Apgar 评分和胎儿畸形等产科并发症的发生率是可以接受的。

结论

妊娠期间附件肿块行腹腔镜手术对胎儿和母亲均提供了可耐受的结局。未来需要更大规模的前瞻性临床试验来充分阐明其对胎儿的影响。

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