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卵巢纤维瘤的腹腔镜手术治疗及临床特征

Laparoscopic surgical management and clinical characteristics of ovarian fibromas.

作者信息

Son Chang Eop, Choi Joong Sub, Lee Jung Hun, Jeon Seung Wook, Hong Jin Hwa, Bae Jong Woon

机构信息

Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (South Korea).

出版信息

JSLS. 2011 Jan-Mar;15(1):16-20. doi: 10.4293/108680810X12924466009087.

Abstract

OBJECTIVE

This study aims to analyze the clinical characteristics and diagnostic features of ovarian fibromas and to evaluate the efficacy and safety of laparoscopic surgery for ovarian fibromas.

METHODS

We reviewed the records of 47 consecutive women who underwent laparoscopic or laparotomic surgeries and whose final histopathological diagnoses were ovarian fibroma, cellular fibroma, or fibrothecoma from January 1999 to August 2010.

RESULTS

During the study period, 49 tumors were removed from 47 women including 27 ovarian fibromas, 19 fibrothecomas, and 3 cellular fibromas. The preoperative diagnoses were ovarian fibroma in 25 women (53.2%) and uterine myoma in 16 women (34.0%). A high serum CA 125 level (>35U/mL) was observed in 15 women, and serum CA 125 level was significantly higher in women with ascites (P=<0.001). The tumors were removed surgically in all women, using the laparotomic approach in 16 women (34.0%) and the laparoscopic approach in 31 women (66.0%). The laparoscopic surgery had the advantages of shorter hospital stay and faster return of bowel activities compared to laparotomy.

CONCLUSIONS

Ovarian fibromas are often misdiagnosed as uterine myomas, and sometimes mistaken for a malignant tumor of the ovary preoperatively. Laparoscopic surgery can be an effective and safe surgical approach for managing ovarian fibromas.

摘要

目的

本研究旨在分析卵巢纤维瘤的临床特征和诊断特点,并评估腹腔镜手术治疗卵巢纤维瘤的疗效和安全性。

方法

我们回顾了1999年1月至2010年8月期间连续47例行腹腔镜或开腹手术且最终组织病理学诊断为卵巢纤维瘤、细胞性纤维瘤或纤维卵泡膜瘤的女性患者的病历。

结果

在研究期间,从47名女性患者中切除了49个肿瘤,其中包括27个卵巢纤维瘤、19个纤维卵泡膜瘤和3个细胞性纤维瘤。术前诊断为卵巢纤维瘤的有25名女性(53.2%),诊断为子宫肌瘤的有16名女性(34.0%)。15名女性患者血清CA 125水平升高(>35U/mL),有腹水的女性患者血清CA 125水平显著更高(P<0.001)。所有女性患者均接受了手术切除肿瘤,16名女性(34.0%)采用开腹手术,31名女性(66.0%)采用腹腔镜手术。与开腹手术相比,腹腔镜手术具有住院时间短和肠道功能恢复快的优点。

结论

卵巢纤维瘤常被误诊为子宫肌瘤,有时术前被误诊为卵巢恶性肿瘤。腹腔镜手术是治疗卵巢纤维瘤的一种有效且安全的手术方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79c7/3134689/81c63523439d/jls0011126910001.jpg

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