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子宫内膜异位症手术前后的卵巢固定术。

Ovariopexy-Before and after Endometriosis Surgery.

作者信息

Dhanawat Juhi, Pape Julian, Freytag Damaris, Maass Nicolai, Alkatout Ibrahim

机构信息

Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, Building 24, 24105 Kiel, Germany.

出版信息

Biomedicines. 2020 Nov 25;8(12):533. doi: 10.3390/biomedicines8120533.

Abstract

Endometriosis surgery is often very challenging. Key to complete resection of endometriosis is access to the retroperitoneum. Endometriosis can involve the ureter and uterine vessels, and ovary on the lateral pelvic wall makes retroperitoneal access difficult. Primary and post-surgical adhesions prevalence in endometriosis is very high. Ovariopexy, transposition of ovaries temporarily, is done for better surgical access and to reduce postoperative adhesions. We concluded that although limited evidence, ovariopexy is an excellent tool to aid endometriosis surgery and prevent postoperative adhesions. It is cost effective, simple and complication rate almost nil. More robust trials are required to substantiate evidence for its impact on preventing postoperative adhesions and its effect on fertility. In this review, we describe our technique of ovariopexy supplemented with a video, with the aim to put light on this useful and important technique, which is beneficial both for surgeons and patients.

摘要

子宫内膜异位症手术通常极具挑战性。完全切除子宫内膜异位症的关键在于进入腹膜后间隙。子宫内膜异位症可累及输尿管、子宫血管,而盆腔侧壁的卵巢会使腹膜后间隙的进入变得困难。子宫内膜异位症中初次手术及术后粘连的发生率非常高。卵巢固定术,即暂时将卵巢移位,目的是为了获得更好的手术视野并减少术后粘连。我们得出结论,尽管证据有限,但卵巢固定术是辅助子宫内膜异位症手术及预防术后粘连的绝佳手段。它具有成本效益、操作简单且并发症发生率几乎为零。需要更有力的试验来证实其对预防术后粘连的影响及其对生育能力的作用。在本综述中,我们描述了我们的卵巢固定术技术并配有视频,旨在阐明这一有用且重要的技术,它对外科医生和患者均有益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7cb/7759852/cec411ba2b17/biomedicines-08-00533-g001.jpg

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