Mohan Surender, Kapoor Garima, Nagpal Praveen Kumar, Aggarwal Raju, Gami Neha
Commandant, Military Hospital , Dehradun, India .
J Clin Diagn Res. 2013 Sep;7(9):1971-4. doi: 10.7860/JCDR/2013/6243.3372. Epub 2013 Aug 17.
Management of Adnexal masses poses a double edged problem. There is a dilemma of performing extensive surgery in the form of staging laparotomy for a benign disease on one hand and the lurking fear of missing the diagnosis of malignancy on the other. Thus, it seems that it is important to establish risk profiles of all patients with adnexal masses so that they can reap the benefit of minimally invasive surgery wherever possible and be rightly subjected to staging laparotomy where indicated.
This prospective study was carried out at a Tertiary care Hospital. 136 women with an adnexal mass on ultrasound which met the said criteria were enrolled into the study from January 2008 to July 2011. They were then taken up for laparoscopic management.
All but 2 cases were found to be benign (134/136) after the final histopathology report using the said criteria.
Hence, by using simple readily available investigations like ultrasound (pattern recognition approach, Tumour morphology and ascites) and CA-125, the nature of adnexal mass can be reliably predicted and these patients can be safely offered the benefits of laparoscopic surgery.
附件肿块的处理是一个双刃剑问题。一方面存在对良性疾病进行广泛手术(如分期剖腹探查术)的困境,另一方面又潜藏着漏诊恶性肿瘤的担忧。因此,似乎重要的是建立所有附件肿块患者的风险概况,以便他们尽可能从微创手术中获益,并在有指征时正确接受分期剖腹探查术。
本前瞻性研究在一家三级护理医院进行。2008年1月至2011年7月,136例超声检查发现有附件肿块且符合上述标准的女性被纳入研究。然后对她们进行腹腔镜治疗。
根据上述标准,最终组织病理学报告显示,除2例病例外,其余所有病例(134/136)均为良性。
因此,通过使用超声(模式识别方法、肿瘤形态和腹水)和CA - 125等简单易获得的检查,附件肿块的性质可以可靠地预测,这些患者可以安全地从腹腔镜手术中获益。