Ripley D, Golden A, Fahs M C, Dottino P
Department of Obstetrics, Mount Sinai School of Medicine, New York, NY, USA.
Mt Sinai J Med. 1999 Jan;66(1):31-4.
The objective of this study is to evaluate the clinical aspects of laparoscopic management of adnexal masses. The feasibility of this approach has been demonstrated, but the safe and effective use of laparoscopy for this indication requires training, technical skills and experience on the part of the laparoscopist. If used appropriately, many patients will benefit from minimally-invasive surgery. We compared clinical factors of patients having laparoscopy to those having laparotomy in a case-control study of 30 patients with adnexal masses. Oophorectomy or ovarian cystectomy was performed by laparoscopy for 20 women and by laparotomy for 10 women. Comparing the 2 groups, the most significant difference was the decrease in length of hospital stay in the laparoscopy group. There were no significant differences in operative time or intraoperative complications. Estimated blood loss was lower in the laparoscopy group, and no intraoperative complications occurred. No patient required conversion from laparoscopy to laparotomy. All patients had benign disease despite the inclusion of patients with risk factors for ovarian carcinoma. This study clearly demonstrates the clinical benefits of laparoscopic management of adnexal masses treated with oophorectomy or ovarian cystectomy.
本研究的目的是评估腹腔镜处理附件肿块的临床情况。这种方法的可行性已得到证实，但要安全有效地将腹腔镜用于这一适应证，需要腹腔镜医师进行培训、具备技术技能和经验。如果使用得当，许多患者将从微创手术中受益。在一项对30例附件肿块患者的病例对照研究中，我们比较了接受腹腔镜手术的患者与接受剖腹手术的患者的临床因素。20名女性通过腹腔镜进行了卵巢切除术或卵巢囊肿切除术，10名女性通过剖腹手术进行了上述手术。比较两组患者，最显著的差异是腹腔镜组住院时间缩短。手术时间或术中并发症方面无显著差异。腹腔镜组估计失血量较少，且未发生术中并发症。没有患者需要从腹腔镜手术转为剖腹手术。尽管纳入了有卵巢癌危险因素的患者，但所有患者均患有良性疾病。本研究清楚地证明了腹腔镜处理行卵巢切除术或卵巢囊肿切除术的附件肿块的临床益处。
