149例腹腔镜下附件包块手术临床分析响.docVIP

149例腹腔镜下附件包块手术临床分析 响 　　作者：刘开江,刘青,唐杰,唐海峰,殷振　　作者单位：新疆医科大学附属肿瘤医院妇外一科，新疆 乌鲁木齐 　　【摘要】目的：探讨腹腔镜在良性附件包块治疗中的安全性和手术适应证。方法：回顾性分析我科2004年5月～2006年11月术前诊断为良性附件包块149例腹腔镜手术治疗情况，从手术的并发症方面评价腹腔镜在附件包块手术中的安全性，从附件包块大小、下腹部手术史两个方面来评价腹腔镜附件手术适应证的拓宽指征。结果：所有附件包块患者均顺利完成腹腔镜手术，术中及术后未见严重并发症。包块直径5 cm与5～8 cm患者的手术时间明显短于≥8 cm患者(q分别为5.54、7.14, P0.05)，不同直径包块患者的术中出血量差异无统计学意义(P0.05)，有无下腹部手术史患者手术时间与术中出血量差异均无统计学意义(P0.05)。结论：腹腔镜附件包块手术安全、可靠，可作为术前诊断为良性附件包块的首选方式。随着腹腔镜器械的发展及手术技巧的提高，对于附件良性肿瘤直径≥8 cm及下腹部手术史患者的适应证可适当拓宽。 　　【关键词】 腹腔镜,附件包块,并发症 　　Abstract: Objective: To investigate the safety and surgical indications of laparoscopy in the treatment of benign adnexal tumors.Methods: A total of 149 patients with benign adnexal tumor in our department from April 2004 to November 2006 were analyzed retrospectively on the treatment of laparoscopic operation.And the safety of laparoscopic operation was evaluated through the complication of surgery on treatment of adnexal tumor.Meanwhile, the enhanced indication of laparoscopic surgery was evaluated through the size of adnexal tumor and history of lower abdominal surgery.Results: All patients with adnexal tumor were operated successfully.There was no serious complication in laparoscopic operation.The time of operation on the patients with tumor which diameter was 5 cm or 5～8 cm was shorter than the time of operation on the patients with ≥8 cm tumor (P0.05). The difference of bleeding volume with different sizes of tumores in operations was not statistically significant (P0.05). Whatever patients were operated, there was no statistical significance between bleeding volume and time of operations (P0.05).Conclusion: The laparoscopic surgery of adnexal tumor is safe and reliable.It can be used for nonmalignant adnexal tumor before operation as preferred method.With the development of laparoscopic instruments and surgical techniques, the indication can be properly widened for adnexal benign tumors ≥8 cm in diameter and patients with a history of lower abdominal surgery.