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本文引用的文献

1
Laparotomy versus laparoscopy for the treatment of adnexal masses during pregnancy.开腹手术与腹腔镜手术治疗孕期附件包块的对比
Aust N Z J Obstet Gynaecol. 2012 Feb;52(1):34-8. doi: 10.1111/j.1479-828X.2011.01380.x. Epub 2011 Nov 17.
2
Left upper quadrant approach in gynecologic laparoscopic surgery.妇科腹腔镜手术中的左上象限入路。
Acta Obstet Gynecol Scand. 2011 Dec;90(12):1406-9. doi: 10.1111/j.1600-0412.2011.01257.x. Epub 2011 Sep 21.
3
Management of a persistent adnexal mass in pregnancy: what is the ideal surgical approach?妊娠合并附件包块的处理：理想的手术方法是什么？
J Minim Invasive Gynecol. 2011 Nov-Dec;18(6):720-5. doi: 10.1016/j.jmig.2011.07.002. Epub 2011 Aug 15.
4
Risks associated with laparoscopic entry: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians.腹腔镜入路相关风险：法国妇产科医师学院临床实践指南。
Eur J Obstet Gynecol Reprod Biol. 2011 Oct;158(2):159-66. doi: 10.1016/j.ejogrb.2011.04.047. Epub 2011 May 31.
5
A 10-year experience of laparoscopic surgery for adnexal masses during pregnancy.妊娠期附件包块腹腔镜手术 10 年经验。
Int J Gynaecol Obstet. 2011 Apr;113(1):36-9. doi: 10.1016/j.ijgo.2010.10.020. Epub 2011 Jan 17.
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Laparoscopic management of complicated adnexal masses in the first trimester of pregnancy.妊娠早期复杂附件包块的腹腔镜处理
Fertil Steril. 2009 Jul;92(1):283-7. doi: 10.1016/j.fertnstert.2008.04.035. Epub 2008 Aug 9.
7
The value of ultrasound visualization of the ovaries during the routine 11-14 weeks nuchal translucency scan.在常规的11至14周颈部透明带扫描期间，超声可视化卵巢的价值。
Eur J Obstet Gynecol Reprod Biol. 2007 Jun;132(2):154-8. doi: 10.1016/j.ejogrb.2006.07.013. Epub 2006 Aug 17.
8
Should we be examining the ovaries in pregnancy? Prevalence and natural history of adnexal pathology detected at first-trimester sonography.我们是否应该在孕期检查卵巢？孕早期超声检查发现的附件病变的患病率及自然病史。
Ultrasound Obstet Gynecol. 2004 Jul;24(1):62-6. doi: 10.1002/uog.1083.
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Adnexal masses and pregnancy: a 12-year experience.附件肿物与妊娠：12年经验总结
Am J Obstet Gynecol. 2003 Aug;189(2):358-62; discussion 362-3. doi: 10.1067/s0002-9378(03)00731-2.
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Laparoscopy for adnexal masses in the second trimester of pregnancy.妊娠中期腹腔镜检查用于附件肿块
J Am Assoc Gynecol Laparosc. 2003 Feb;10(1):55-9. doi: 10.1016/s1074-3804(05)60235-6.

孕期附件肿块的手术治疗

Surgical management of adnexal masses in pregnancy.

作者信息

Ngu Siew-Fei, Cheung Vincent Y T, Pun Ting-Chung

机构信息

Department of Obstetrics and Gynecology, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Hong Kong SAR.

Department of Obstetrics and Gynecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR.

出版信息

JSLS. 2014 Jan-Mar;18(1):71-5. doi: 10.4293/108680813X13693422521007.

DOI:10.4293/108680813X13693422521007
PMID:24680147
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3939346/
Abstract

BACKGROUND AND OBJECTIVES

Our objective was to review the surgical management, surgical outcomes, and obstetric outcomes of adnexal masses in pregnancy.

METHODS

A retrospective review was performed of pregnant women before 20 weeks of gestation who underwent laparoscopy or laparotomy for management of an adnexal mass during the period of January 2005 to June 2012 at a university-affiliated hospital.

RESULTS

Thirty-five pregnant women underwent surgical removal of adnexal masses during the 7.5-year study period: 21 (60.0%) underwent laparoscopic surgery, and 14 (40.0%) underwent laparotomy. The left upper quadrant entry technique was used in 20 women. Conversion to laparotomy was required in 2 women because of extensive pelvic adhesions. The mean gestational age at surgery was 15.2 ± 1.9 weeks. All women had undergone ovarian cystectomy. A malignant mass was found in 3 (8.6%) women. The laparoscopy group had a significantly less blood loss (67.4 ± 55.8 vs 153.6 ± 181.0 mL, P = .048) and shorter mean hospital stay (2.8 ± 1.0 vs 3.8 ± 1.1 days, P = .006) than the laparotomy group. One woman miscarried soon after surgery. There was no significant difference in obstetric outcomes between the laparoscopy and laparotomy groups.

CONCLUSION

Surgical management of adnexal masses during pregnancy appears to have favorable outcomes for the mother and the fetus.

摘要

背景与目的

我们的目的是回顾妊娠合并附件包块的手术治疗、手术结局及产科结局。

方法

对2005年1月至2012年6月期间在一所大学附属医院妊娠20周前因附件包块接受腹腔镜或开腹手术的孕妇进行回顾性研究。

结果

在7.5年的研究期间，35名孕妇接受了附件包块切除术：21例（60.0%）接受了腹腔镜手术，14例（40.0%）接受了开腹手术。20名女性采用左上腹入路技术。2名女性因广泛盆腔粘连而需要中转开腹。手术时的平均孕周为15.2±1.9周。所有女性均接受了卵巢囊肿切除术。3例（8.6%）女性发现为恶性包块。腹腔镜组的失血量明显少于开腹组（67.4±55.8 vs 153.6±181.0 mL，P = 0.048），平均住院时间也明显短于开腹组（2.8±1.0 vs 3.8±1.1天，P = 0.006）。1名女性术后不久流产。腹腔镜组和开腹组的产科结局无显著差异。

结论

妊娠期间附件包块的手术治疗对母亲和胎儿似乎都有良好的结局。