Parker W H, Levine R L, Howard F M, Sansone B, Berek J S
Department of Obstetrics and Gynecology, University of California, Los Angeles School of Medicine.
J Am Coll Surg. 1994 Dec;179(6):733-7.
The objective of this study was to determine the ability to predict benign adnexal masses in postmenopausal women and to evaluate the effectiveness of laparoscopic management in selected patients.
Postmenopausal women found to have an adnexal mass were prospectively evaluated with clinical examination, sonography, and serum CA-125 levels. Women with cystic masses greater than 3 cm but less than 10 cm, with distinct borders, without solid parts or septations greater than 2 mm, without ascites or matted bowel, and with serum CA-125 levels less than 35 IU per mL were operated upon by laparoscopy.
Sixty-one women gave consent for the study. Cyst size ranged from 3 to 10 cm. All masses were accurately predicted to be benign. Fifty-eight (95 percent) women were successfully managed by operative laparoscopy and three required laparotomy. For the patients managed by laparoscopy, the mean operative time was 63 minutes, the mean postoperative hospitalization period was 12 hours, and the mean return to normal activity was 5.6 days.
The combination of clinical examination, sonographic appearance and serum CA-125 levels can accurately predict benign masses in postmenopausal women. Operative laparoscopy is acceptable for these patients and provides for a short period of hospitalization and a rapid recovery.
本研究的目的是确定预测绝经后妇女附件良性肿块的能力，并评估腹腔镜手术治疗特定患者的有效性。
对发现有附件肿块的绝经后妇女进行前瞻性临床检查、超声检查和血清CA-125水平检测。对囊肿直径大于3cm但小于10cm、边界清晰、无实性成分或分隔大于2mm、无腹水或肠粘连且血清CA-125水平低于35IU/mL的妇女进行腹腔镜手术。
61名妇女同意参与本研究。囊肿大小在3至10cm之间。所有肿块均被准确预测为良性。58名（95%）妇女通过腹腔镜手术成功治疗，3名需要开腹手术。对于接受腹腔镜手术的患者，平均手术时间为63分钟，平均术后住院时间为12小时，平均恢复正常活动时间为5.6天。
临床检查、超声表现和血清CA-125水平相结合可准确预测绝经后妇女的良性肿块。腹腔镜手术对这些患者是可行的，且住院时间短、恢复快。
