Webb M J
Section of Gynecologic Surgery, Mayo Clinic, Rochester, MN 55905.
Aust N Z J Obstet Gynaecol. 1989 Nov;29(4):433-5. doi: 10.1111/j.1479-828x.1989.tb01783.x.
Twenty-seven patients with ovarian remnant syndrome were operated on by the author in a 7-year period. All patients presented with pelvic pain as their major symptom. A mass was palpable in 20 patients. In 3 patients, no mass was palpable but a lesion was visible on computed tomographic scanning. In 4 patients, there was no palpable mass and scans were negative, yet an ovarian remnant was found at laparotomy. Segmental bowel resection was necessary to obtain clearance in 8 patients, and partial bladder resection was performed in 2. Previous pelvic operations (mean, 4.3) in this group of patients probably contributed to the development of this syndrome. The ovarian remnant syndrome occurs in a patient who has previously had a bilateral salpingo-oophorectomy. A piece of ovarian tissue remains, and this remnant often produces symptoms, usually pelvic pain and associated dyspareunia. Usually the patient has had a hysterectomy as well as bilateral salpingo-oophorectomy, so that the pain is often dismissed as 'not gynaecological' in origin. This syndrome is not synonymous with residual ovary syndrome, in which an ovary that has previously been intentionally conserved either develops an abnormal pathological process or causes symptoms necessitating its surgical removal (6). Unfortunately, awareness of the problems caused by an ovarian remnant is not widespread, and often these patients have been to many gynaecologists, general surgeons, or even psychiatrists in an attempt to get relief from their symptoms. It is not possible to estimate the incidence of symptomatic ovarian remnants, but certainly when an awareness of the syndrome develops, referral of patients with the problem is common.
在7年时间里，作者对27例卵巢残端综合征患者进行了手术。所有患者均以盆腔疼痛为主要症状。20例患者可触及肿块。3例患者未触及肿块，但计算机断层扫描可见病变。4例患者未触及肿块且扫描结果为阴性，但剖腹手术时发现了卵巢残端。8例患者需要进行节段性肠切除以清除病灶，2例患者进行了部分膀胱切除。该组患者先前的盆腔手术（平均4.3次）可能促成了该综合征的发生。卵巢残端综合征发生在先前接受过双侧输卵管卵巢切除术的患者身上。会残留一块卵巢组织，而这块残端通常会产生症状，通常是盆腔疼痛和相关的性交困难。通常患者还接受了子宫切除术以及双侧输卵管卵巢切除术，因此疼痛常常被认为“并非源于妇科”。该综合征与残留卵巢综合征不同，在残留卵巢综合征中，先前有意保留的卵巢要么发生异常病理过程，要么引起需要手术切除的症状（6）。不幸的是，对卵巢残端引起的问题的认识并不普遍，而且这些患者常常找过许多妇科医生、普通外科医生，甚至精神科医生，试图缓解症状。目前尚无法估计有症状的卵巢残端的发生率，但当对该综合征的认识提高后，有此问题的患者前来就诊的情况很常见。
