Bolla D, Deseö N, Sturm A, Schöning A, Leimgruber C
Department of Obstetrics and Gynecology, Spitalregion Fürstenland Toggenburg, 9500 Wil, Switzerland.
Case Rep Obstet Gynecol. 2012;2012:589568. doi: 10.1155/2012/589568. Epub 2012 Mar 5.
Mature cystic teratomas (MCTs) of the ovary represent 44% of ovarian neoplasmas. The surgical approach is important in young women especially for the cosmetic results. Nowadays most of the ovarian surgeries can be performed laparoscopically. An alternative between laparoscopy and laparotomy is the minilaparotomy (ML) which can be an interesting option, thanks to the small incision. We report a 39-year-old woman who was referred to our hospital with acute abdominal pain. In her past history the patient had an uncomplicated delivery. During pregnancy a 6 cm bilateral MCT was diagnosed and expectant management was followed. A left-sided ovarial torsion was postulated, and laparoscopic detorsion was performed. To avoid a rupture of the left MCT, the operation was interrupted. To remove the cyst, a ML was done two weeks later. A left-sided salpingo-oophorectomy was performed due to a large cyst including the entire ovary. On the other side, the right dermoid cyst was entirely removed. The advantage of a ML is not only shorter operating time with less learning curve compared to laparoscopy but also the possibility to extract the adnexal mass from the abdominal cavity with lower risk of rupture and in addition the possibility to preserve more ovarian tissue.
卵巢成熟囊性畸胎瘤（MCTs）占卵巢肿瘤的44%。手术方式对年轻女性很重要，尤其是在美容效果方面。如今，大多数卵巢手术都可以通过腹腔镜进行。腹腔镜手术和剖腹手术之间的一种替代方法是小切口剖腹术（ML），由于切口小，它可能是一个有趣的选择。我们报告一位39岁女性，因急性腹痛被转诊至我院。患者既往分娩顺利。孕期诊断出双侧6cm的MCT，采取了期待治疗。推测为左侧卵巢扭转，遂行腹腔镜扭转复位术。为避免左侧MCT破裂，手术中断。两周后为切除囊肿进行了小切口剖腹术。因囊肿较大累及整个卵巢，故行左侧输卵管卵巢切除术。另一侧的皮样囊肿被完整切除。小切口剖腹术的优点不仅是与腹腔镜手术相比手术时间更短、学习曲线更平缓，而且有从腹腔取出附件包块的可能性，破裂风险更低，此外还有可能保留更多的卵巢组织。
