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[腹腔镜治疗附件肿瘤]

[Treatment of adnexal tumors with laparoscopy].

作者信息

Treviño Alanís R, Martínez Ramírez A, Garza Treviño F G, Calanda A

机构信息

Hospital San José, Monterrey NL, México.

出版信息

Ginecol Obstet Mex. 1997 Apr;65:131-6.

PMID:9280737
Abstract

This article shows the experience in 61 patients with adnexal tumors studied from June 1988 to June 1994; the origin of the patients in private and semiprivate, to whom we practiced a diagnostic and operative laparoscopy (56/61) at the same time. The inclusion and exclusion criteria were determined by clinical history (past history, age, symptoms, size, etc.), vaginal ultrasonography scan (ascites, papillas, cyst's content, etc.), laboratory tests (Ca 125 in postmenopausal patients), the macroscopic assessment during the diagnostic laparoscopy, transoperative biopsy (19/61) was made in order to confirm the benign findings seen before laparoscopy; and the results were accordingly on the 61 cases. The cause of consult was infertility in 24/61; 18/61 were primary infertility; 6/61 were secondary infertility. We did 22 cystectomies and 2 oophorectomies; 10 of them became pregnant. 37 from 61 had pain, nine of this group we did an oophorectomy (2 by torsion, 3 had hemorrhagic cysts that were ruptured and 4 were residual ovary), the rest 28 we performed cystectomy with frank improvement of their symptoms. The postoperative diagnosis of the tumors were: luteomas 13/61; functional cysts 17/61, Hemorrhagic cysts 8/61; endometriomas 9/61; serous cystoadenoma 3/61; mucinous cystoadenoma 1/61; ovaric fibroma 1/61; mature cystic teratoma 2/61; residual ovaries 4/61; paraovaric cysts 2/61 and Morgagni's hydatide 1/61. It is concluded that if one follows all the correct parameters for the evaluation of adnexal tumors, the endoscopic procedure could be safe with the benefits of the laparoscopic procedure.

摘要

本文展示了1988年6月至1994年6月期间对61例附件肿瘤患者的研究经验;患者来自私立和半私立机构,我们同时对他们进行了诊断性和手术性腹腔镜检查(56/61)。纳入和排除标准由临床病史(既往史、年龄、症状、大小等)、阴道超声扫描(腹水、乳头、囊肿内容物等)、实验室检查(绝经后患者的Ca 125)、诊断性腹腔镜检查期间的宏观评估确定,为了确认腹腔镜检查前所见的良性结果进行了术中活检(19/61);并据此给出了61例病例的结果。就诊原因是不孕的有24/61;18/61是原发性不孕;6/61是继发性不孕。我们做了22例囊肿切除术和2例卵巢切除术;其中10例怀孕。61例中有37例有疼痛,该组中有9例我们做了卵巢切除术(2例因扭转,3例有破裂的出血性囊肿,4例是残留卵巢),其余28例我们做了囊肿切除术,其症状明显改善。肿瘤的术后诊断为:黄体瘤13/61;功能性囊肿17/61,出血性囊肿8/61;子宫内膜异位症9/61;浆液性囊腺瘤3/61;黏液性囊腺瘤1/61;卵巢纤维瘤1/61;成熟囊性畸胎瘤2/61;残留卵巢4/61;副卵巢囊肿2/61和 Morgagni 氏囊状附件1/61。结论是,如果遵循所有评估附件肿瘤的正确参数,内镜手术可能是安全的,并具有腹腔镜手术的益处。

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