Department of Gynecological Oncology, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin, China.
Int J Gynecol Cancer. 2018 Feb;28(2):274-278. doi: 10.1097/IGC.0000000000001170.
We investigated the short-term outcomes and pregnancy rate after a laparoscopic approach to fertility preservation in patients with borderline ovarian tumors (BOTs).
Clinic-pathologic variants of patients with BOTs who underwent conservative surgery at the Tianjin Central Hospital of Obstetrics and Gynecology between January 2009 and July 2015 were retrospectively analyzed.
Among 211 patients with BOTs, 74 (35.1%) received conservative surgery (44 cases using a laparoscopic approach and 30 cases using a laparotomy approach). The mean age of the laparotomy group was significantly younger than that of the laparoscopic group (P = 0.024). The maximal longitude of the tumor in the laparotomy group was significantly longer than that in the laparoscopic group (P < 0.001). The number of incomplete surgery cases in the laparoscopic group was significantly greater than that in the laparotomy group (P < 0.001). The 2 groups showed no significant differences in gravidity and parity before surgery, abnormality of serum tumor makers, tumor lateralities, ascites, histology, duration of follow-up, pregnancy rate after surgery, or postoperative recurrence. Total recurrent rate was 6.7% (5/74). Two cases in laparotomy group and 3 cases in laparoscopic group relapsed respectively. There was no significant difference of recurrent rate between the 2 groups. The total pregnant rate was 33.8% (25/74). Nine patients (30%) in the laparotomy group and 16 patients (36.4%) in the laparoscopic group became pregnant during follow-up respectively. There were no significant differences in the postoperative durations of pregnancy, pregnancy type, age at pregnancy, tumor lateralities, ascites, or type of pathology between 2 groups. The pregnancy rate of incomplete surgery cases in laparoscopic group was significantly higher than that of laparotomy group (P = 0.011). No recurrence occurred among the pregnant cases.
A comprehensive laparoscopic surgery was not performed in incomplete surgery patients undergoing complete exploration. Good short-term outcomes and pregnancy were observed in patients receiving conservative laparoscopic surgery for BOTs, especially in patients receiving incomplete conservative laparoscopic surgery.
探讨腹腔镜保留生育功能手术治疗交界性卵巢肿瘤（BOT）的近期疗效和妊娠率。
回顾性分析 2009 年 1 月至 2015 年 7 月在天津市中心妇产科医院接受保留生育功能手术的 BOT 患者的临床病理特征。
211 例 BOT 患者中，74 例行保留生育功能手术（腹腔镜 44 例，开腹 30 例）。开腹组的平均年龄明显小于腹腔镜组（P = 0.024）。开腹组肿瘤最长径明显长于腹腔镜组（P < 0.001）。腹腔镜组不完全手术例数明显多于开腹组（P < 0.001）。两组患者术前孕次、产次、血清肿瘤标志物异常、肿瘤侧别、腹水、组织学类型、随访时间、术后妊娠率及术后复发情况差异均无统计学意义。总复发率为 6.7%（5/74）。开腹组 2 例，腹腔镜组 3 例复发。两组复发率差异无统计学意义。总妊娠率为 33.8%（25/74）。开腹组 9 例（30%），腹腔镜组 16 例（36.4%）妊娠。两组术后妊娠持续时间、妊娠类型、妊娠年龄、肿瘤侧别、腹水及病理类型差异均无统计学意义。腹腔镜组不完全手术病例的妊娠率明显高于开腹组（P = 0.011）。妊娠病例无复发。
对于接受全面探查的不完全手术患者，未行综合腹腔镜手术。对于接受 BOT 保留生育功能腹腔镜手术的患者，尤其是接受不完全保留生育功能腹腔镜手术的患者，观察到良好的近期疗效和妊娠率。
