腹腔镜手术治疗妊娠期卵巢良性肿瘤16例临床分析

Laparoscopy in treatment of benign ovarian tumor in 16 pregnant women

摘要:

目的 探讨腹腔镜手术治疗妊娠期卵巢良性肿瘤的临床价值。方法 回顾性分析该院2003年11月-2013年10月16例妊娠期卵巢良性肿瘤的临床资料。患者均为单胎妊娠，平均年龄（28.0±5.1）岁，手术孕周为7~23周，其中，孕早期5例，孕中期11例，4例患者合并蒂扭转，其余12例均为产检时超声发现，卵巢肿瘤均为单侧，平均直径为（121.5±59.6）mm。结果 所有患者均成功施行腹腔镜手术，无1例中转开腹及发生围术期并发症。6例行腹腔镜患侧附件切除术；10例行腹腔镜卵巢肿瘤剥除术，其中1例同时行卵巢肿瘤蒂扭转复位，2例同时行盆腔粘连松解术，术后病理均证实为良性。手术时间30～165 min，术中出血（32.1±5.6）ml，术后排气时间（19.6±3.2）h，术后住院（5.3±1.7）d。术后2例患者孕早期放弃妊娠，2例继续围产期保健，其余12例均已足月分娩，新生儿出生后Apgar评分均为9～10分，出生体重2 650～3 700 g。经电话随访，已分娩者后代的运动和智力发育均无明显异常，年龄最大者为6岁。结论 腹腔镜手术诊治妊娠期卵巢良性肿瘤是安全有效的，不影响妊娠结局。

Abstract:

【Objective】 To evaluate the clinical value of laparoscopic surgery for benign ovarian tumors during pregnancy. 【Methods】 Sixteen singleton pregnant women identified with surgically proven benign ovarian tumors from November 2003 to December 2013 in Zhujiang Hospital were analyzed retrospectively. The average age was (28.0±5.1) years old, 5 in the first trimester, 11 in the second. 4 patients were admitted to hospital for torsion, and others for obstetrical ultrasound. The average diameter of tumor was (121.5±59.6) mm. 【Results】 All patients underwent laparoscopic surgery with no complication and no conversion to an open procedure. 6 subjects underwent laparoscopic resection of the affected side annex. 10 subjects underwent laparoscopic excision of ovarian tumor together with one distortion and pelvic adhesion lysis, respectively. All cases were diagnosised benign pathologically. The operation time was 30~165 min. Blood loss was (32.1±5.6) mL. Time of resumption of gastrointestinal function was (19.6±3.2) h. Postoperation stay was (5.3±1.7) d. The outcomes of pregnancy varied: 2 elective abortions in the first trimester, 2 ongoing pregnancies at the time of writing and others continued to term. The Apgar score of neoborn was 9~10 and the birth weight was 2 650~3 700 g. 【Conclusion】 Laparoscopic management for benign ovarian tumors during pregnancy is safe and effective, which does no harm to mother and fetus.