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[孕期卵巢囊肿的管理:里尔的经验及文献综述]

[Management of ovarian cysts during pregnancy: Lille's experience and literature review].

作者信息

Cohen-Herriou K, Semal-Michel S, Lucot J-P, Poncelet E, Rubod C

机构信息

Service de gynécologie obstétrique, hôpital Jeanne-de-Flandre, CHRU de Lille, Lille, France.

出版信息

Gynecol Obstet Fertil. 2013 Jan;41(1):67-72. doi: 10.1016/j.gyobfe.2012.12.001. Epub 2013 Jan 8.

Abstract

OBJECTIVE

The aim of our study was to evaluate the practice of Lille in the management of ovarian cyst during pregnancy and to compare our results with data from the literature.

PATIENTS AND METHODS

The study was a retrospective cohort of Lille University Hospital between 1st January 2007 and 31st December 2010. The inclusion was based on the ultrasound diagnosis of an ovarian cyst greater or equal to 30mm during pregnancy. Obstetrical and neonatal data, surgical techniques and indications were analyzed.

RESULTS

Seventy-one patients had a diagnosis of ovarian cyst during pregnancy, i.e., 0.35% of pregnancies followed at the University Hospital of Lille during the study period. The diagnosis took place in the first quarter in the majority of cases, at 12.30±6.99 weeks of amenorrhea (WA). Most often, the ovarian cyst is monitored during pregnancy, which has been strictly the case in 63.38% of cysts (45 patients). Fourteen patients had to be operated during pregnancy (19.72%). There were 7 emergency interventions and 7 programmed intrapartum interventions. Five intrapartum laparoscopies were performed at a mean term of 14.75±2.63 WA, and 9 laparotomies were performed at a mean term of 18.88±4.57 WA. Twelve ovarian mass surgeries were performed per caesarean section. Operated cysts are most often organic cysts (74.39%). No malignancies were observed, and 3 cases of borderline tumors were diagnosed. There were no obstetrical or neonatal complications.

DISCUSSION AND CONCLUSION

A simple monitoring is possible if the cyst is benign, less than 6cm and does not change. Surgery is required in an emergency or in case of suspicious signs of complications or malignancy. Laparoscopy can be widely used until the 2nd quarter. Lille's attitude respects the recommendations is consistent with the literature.

摘要

目的

我们研究的目的是评估里尔在孕期卵巢囊肿管理方面的做法,并将我们的结果与文献数据进行比较。

患者与方法

该研究是对里尔大学医院2007年1月1日至2010年12月31日期间的回顾性队列研究。纳入标准为孕期超声诊断卵巢囊肿直径大于或等于30mm。分析了产科和新生儿数据、手术技术及指征。

结果

71例患者在孕期被诊断为卵巢囊肿,即研究期间在里尔大学医院接受随访的妊娠病例中的0.35%。大多数病例诊断发生在第一季度,闭经(WA)12.30±6.99周。多数情况下,卵巢囊肿在孕期接受监测,63.38%的囊肿(45例患者)严格如此。14例患者在孕期必须接受手术(19.72%)。有7例急诊手术和7例计划中的产时手术。5例产时腹腔镜手术平均在WA 14.75±2.63周进行,9例剖腹手术平均在WA 18.88±4.57周进行。每例剖宫产同时进行12例卵巢肿物手术。手术切除的囊肿大多为器质性囊肿(74.39%)。未观察到恶性肿瘤,诊断出3例交界性肿瘤。无产科或新生儿并发症。

讨论与结论

如果囊肿为良性、小于6cm且无变化,则可进行简单监测。在紧急情况或出现并发症或恶性肿瘤可疑迹象时需要手术。腹腔镜检查可在第二季度前广泛应用。里尔的态度符合推荐意见,与文献一致。

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