Chapron C, Dubuisson J B, Samouh N, Foulot H, Aubriot F X, Amsquer Y, Morice P
Clinique Universitaire Port-Royal, C.H.U. Cochin Port-Royal, Paris, France.
Surg Endosc. 1994 Sep;8(9):1092-5. doi: 10.1007/BF00705727.
The purpose of this study was to discuss the place and the specific modalities of laparoscopic surgery in the management of ovarian dermoid cysts. This retrospective and noncomparative study was carried out in 65 patients who presented dermoid ovarian cyst between January 1986 and December 1990 in our institution. The surgical treatment was performed purely by laparoscopy in 86.2% of the cases (56 patients). The modalities of laparoscopic surgery were as follows: ovariectomy (8 cases; 14.3%), transparietal cystectomy (4 cases; 7.1%) and intraperitoneal cystectomy (44 cases; 78.6%). In 15 cases (15/44 = 34%) the intraperitoneal cystectomy was carried out without opening the cyst and the intact cyst was extracted using an endoscopic impermeable sack. We observed no cases of chemical peritonitis. The risk of recurrence after conservative treatment is 4% (two patients) and out of the ten patients for whom a second-look laparoscopy was performed only two (20%) presented adhesions. Laparoscopic treatment of dermoid ovarian cysts is feasible, safe, and effective. The treatment can be conservative in over 80% of the cases. The specific risk of chemical peritonitis can be countered by a change in the cystectomy technique. The use of an impermeable laparoscopic sack permits extraction of the cyst without any peritoneal contamination.
本研究的目的是探讨腹腔镜手术在卵巢皮样囊肿治疗中的地位及具体方式。本回顾性非对照研究纳入了1986年1月至1990年12月间在我院就诊的65例卵巢皮样囊肿患者。86.2%的病例（56例）单纯通过腹腔镜进行手术治疗。腹腔镜手术方式如下：卵巢切除术（8例；14.3%）、经壁囊肿切除术（4例；7.1%）和腹腔内囊肿切除术（44例；78.6%）。在15例（15/44 = 34%）腹腔内囊肿切除术中，未打开囊肿，而是使用内镜不透水袋完整取出囊肿。我们未观察到化学性腹膜炎病例。保守治疗后复发风险为4%（2例患者），在接受二次腹腔镜检查的10例患者中，只有2例（20%）出现粘连。腹腔镜治疗卵巢皮样囊肿是可行、安全且有效的。超过80%的病例可采用保守治疗。通过改变囊肿切除技术可应对化学性腹膜炎的特定风险。使用不透水腹腔镜袋可在不污染腹膜的情况下取出囊肿。
