腹腔镜引导下小切口开腹术：一种治疗良性大型卵巢囊肿的改良技术。
Laparoscopic guided minilaparotomy: a modified technique for management of benign large ovarian cysts.
机构信息
Obstetrics and Gynecology Department, Cairo University, Kasr Alainy Street, Giza, 12111, Egypt.
出版信息
BMC Womens Health. 2022 Jul 4;22(1):269. doi: 10.1186/s12905-022-01853-4.
BACKGROUND
The aim of the study is to evaluate the efficiency and safety of a novel technique to treat large benign ovarian cysts combining benefits of laparoscopic management along with mini-laparotomy without affection of the ovarian reserve.
METHODS
The study included 112 women with large benign ovarian cyst candidate for ovarian cystectomy. The technique started with laparoscopy followed by guided cyst aspiration followed by exteriorization of the ovary through minilaprotomy and completion of cystectomy through microsurgical technique. The primary outcome was ipsilateral recurrence of the cyst. Other outcomes included ovarian reserve assessment and postoperative pain.
RESULTS
The number of women with recurrence in the ipsilateral ovary after 12, 18 and 24 months were 5 (4.5%),16 (14.3%),20 (17.85%) respectively. Assessment of ovarian reserve revealed a significant decrease in the level of serum AMH (2.82 ± 0.44 vs. 2.50 ± 0.42) and a significant increase in AFC (3.5 ± 1.7 vs. 4.9 ± 1.3) after our novel technique in surgical treatment of ovarian cysts (P value < 0.001). The operative time was 50 ± 7 and 62 ± 7 min in unilateral and bilateral cysts respectively.
CONCLUSIONS
Laparoscopic guided minilaparotomy is a safe and effective technique for the management of large benign ovarian cysts with minimal recurrence rate, ovarian reserve affection and adhesions.
TRIAL REGISTRATION
clinical trial registry no. NCT03370952. Registered 13 December 2017, https://clinicaltrials.gov/ct2/show/NCT03370952.
背景
本研究旨在评估一种新的治疗大型良性卵巢囊肿的技术的效率和安全性，该技术结合了腹腔镜管理的优势和小切口开腹术，同时不影响卵巢储备功能。
方法
该研究纳入了 112 名适合行卵巢囊肿切除术的大型良性卵巢囊肿患者。该技术首先采用腹腔镜，然后进行囊肿引导抽吸，接着通过小切口将卵巢引出，并通过显微外科技术完成囊肿切除术。主要结局是同侧囊肿复发。其他结局包括卵巢储备功能评估和术后疼痛。
结果
术后 12、18 和 24 个月时，同侧卵巢复发的女性分别为 5 例（4.5%）、16 例（14.3%）和 20 例（17.85%）。卵巢储备功能评估显示，采用新术式治疗卵巢囊肿后，血清 AMH 水平显著下降（2.82±0.44 比 2.50±0.42），AFC 显著增加（3.5±1.7 比 4.9±1.3）（P 值均<0.001）。单侧和双侧囊肿的手术时间分别为 50±7 和 62±7 分钟。
结论
腹腔镜引导下小切口开腹术是一种安全有效的治疗大型良性卵巢囊肿的方法，其复发率低、对卵巢储备功能影响小且粘连少。
试验注册
临床试验注册号 NCT03370952。注册日期：2017 年 12 月 13 日，https://clinicaltrials.gov/ct2/show/NCT03370952。
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