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妊娠期间腹腔镜手术与剖腹手术治疗卵巢囊肿的对比分析

Comparative analysis of laparoscopy versus laparotomy in the management of ovarian cyst during pregnancy.

作者信息

Chen Limei, Ding Jingxin, Hua Keqin

出版信息

J Obstet Gynaecol Res. 2014 Mar;40(3):763-9. doi: 10.1111/jog.12228.

Abstract

AIM

The aim of the present study was to evaluate the surgical and obstetric results of laparoscopy versus laparotomy in the management of ovarian cyst during pregnancy.

MATERIAL AND METHODS

Sixty-nine eligible patients who met our criteria were randomly divided into the laparoscopy group (n = 33) and the laparotomy group (n = 36). The two groups were compared for their surgical and obstetric outcomes and the extent of pelvic adhesion discovered in later cesarean section (CS).

RESULTS

The laparoscopy group had less blood loss (43 ± 15 vs 51 ± 13 mL, P = 0.02), shorter postoperative hospital stay (2.9 ± 0.5 vs 5.8 ± 0.6 days, P < 0.001), and lower postoperative pain score (2.7 ± 1.2 vs 5.9 ± 1.5, P < 0.001) compared with the laparotomy group. The operative time, neonates' Apgar scores and birthweights between the two groups showed no significant differences (P > 0.05). Sixteen patients in the laparoscopy group, and 15 patients in the laparotomy group underwent cesarean section. The filmy and dense type adhesion rate was significantly different between the laparoscopy group and the laparotomy group (6.25% vs 53.3%, and 0% vs 20%, respectively).

CONCLUSIONS

The present results suggest that laparoscopy is a better choice than laparotomy for ovarian cyst during pregnancy, with less blood loss, less postoperative pain and less postoperative hospital stay. It offers a faster recovery, results in less pelvic adhesion and does not affect the fetus; however, studies encompassing larger numbers of cases are needed.

摘要

目的

本研究旨在评估腹腔镜手术与开腹手术治疗妊娠期卵巢囊肿的手术及产科结局。

材料与方法

69例符合标准的合格患者被随机分为腹腔镜组(n = 33)和开腹组(n = 36)。比较两组的手术及产科结局,以及后续剖宫产术中发现的盆腔粘连程度。

结果

与开腹组相比,腹腔镜组术中失血更少(43±15 vs 51±13 mL,P = 0.02),术后住院时间更短(2.9±0.5 vs 5.8±0.6天,P < 0.001),术后疼痛评分更低(2.7±1.2 vs 5.9±1.5,P < 0.001)。两组的手术时间、新生儿阿氏评分及出生体重无显著差异(P > 0.05)。腹腔镜组16例患者和开腹组15例患者接受了剖宫产。腹腔镜组与开腹组的薄膜状和致密型粘连率有显著差异(分别为6.25% vs 53.3%,以及0% vs 20%)。

结论

目前的结果表明,对于妊娠期卵巢囊肿,腹腔镜手术是比开腹手术更好的选择,具有术中失血少、术后疼痛轻、术后住院时间短的优点。它恢复更快,导致盆腔粘连更少,且不影响胎儿;然而,需要纳入更多病例的研究。

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