经脐单孔腹腔镜手术治疗巨大附件良性肿瘤30例

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英文篇名：Transumbilical Single-site Laparoscopic Surgery for Giant Benign Adnexal Tumors: Report of 30 Cases 作者：孙力 ; 张旋 ; 杨萌 ; 谭化明 ; 杨文静 ; 郭铭川 ; 潘玉英 ; 陈珂瑶 英文作者：Sun Li;Zhang Xuan;Yang Meng;Department of Gynecology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College; 关键词：单孔腹腔镜手术 ; 附件肿瘤 ; 腹腔镜 英文关键词：Single-site laparoscopic surgery;;Adnexal tumor;;Laparoscopy 中文刊名：ZWWK 英文刊名：Chinese Journal of Minimally Invasive Surgery 机构：国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院深圳医院妇科; 出版日期：2019-04-20 出版单位：中国微创外科杂志 年：2019 期：v.19;No.217 语种：中文; 页：ZWWK201904005 页数：3 CN：04 ISSN：11-4526/R 分类号：26-28

摘要

目的探讨经脐单孔腹腔镜手术治疗巨大附件良性肿瘤可行性和安全性。方法 2017年10月～2018年11月同一术者对30例巨大附件良性肿瘤实施单孔腹腔镜手术,采用经脐入路,1. 5～2. 0 cm切口置入切口保护套及Port,用相关腹腔镜器械完成经脐单孔腹腔镜手术,手术方式包括卵巢囊肿剔除术、附件切除术、全子宫+单附件或双附件切除术。结果 30例均成功完成经脐单孔腹腔镜手术,无一例增加辅助穿刺孔或中转开腹,其中卵巢囊肿剔除术8例,单/双附件切除13例,全子宫+单附件或双附件切除9例。术中囊肿破裂2例(6. 7%)。无一例术中、术后并发症。术后病理均良性肿瘤,无一例交界瘤或恶性肿瘤,其中浆液性囊腺瘤9例,成熟囊性畸胎瘤8例,黏液性囊腺瘤7例,纤维瘤、子宫内膜异位囊肿、单纯囊肿各2例。术后住院时间中位数4 d(1～10 d)。30例中位随访时间6. 5月(1～12个月),无一例复发。结论经脐腹腔镜手术治疗巨大附件良性肿瘤安全、可行。
        Objective To investigate the feasibility and safety of transumbilical single-site laparoscopic surgery for large adnexal tumors. Methods From October 2017 to November 2018,30 patients with giant benign adnexal tumors underwent singlesite laparoscopic surgery. The surgery was performed with a 1. 5-2. 0 cm incision through the umbilical access. The operation was conducted by using relevant laparoscopic instruments. The procedures included cystectomy,adnexectomy,unilateral/bilateral salpingooophorectomy combined with total hysterectomy. Results All the surgeries were successfully completed by the same surgeon. No additional ports were required or conversion to laparotomy. There were 8 cases of cystectomy,13 cases of adnexectomy,and 9 cases of salpingo-oophorectomy combined with total hysterectomy. Intraoperative cyst rupture occurred in 2 cases( 6. 7%). No intraoperative or postoperative complications were observed. Postoperative pathological results showed benign tumors in all the cases,without ovarian borderline tumors or malignant tumors. There were serous cystadenoma in 9 cases,mature cystic teratoma in 8 cases,mucinous cystadenoma in 7 cases,fibroids in 2 cases,endometriotic cysts in 2 cases,and simple cysts in 2 cases,respectively. The median postoperative hospital stay was 4 d( range,1-10 d). The median follow-up time was 6. 5 months( range,1-12 months),and no recurrence occurred. Conclusion Transumbilical laparoscopic single-site surgery for giant benign adnexal tumors may be a safe and feasible procedure.

引文

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