摘要
目的 探讨多孔腹腔镜手术(MILS)与开腹手术在治疗妊娠早中期卵巢良性肿瘤蒂扭转(BOTT)的效果及对妊娠结局的影响.方法 将2013年2月至2023年1月首都医科大学附属北京妇产医院及清华大学第一附属医院收治的92例妊娠早中期BOTT孕妇纳入本次回顾性研究,根据手术方式的不同分为开腹组(n=40)和MILS组(n=52).比较2组患者围术期指标[包括肿瘤直径、扭转角度、缺血等级、手术时间、术中出血量、术后通气时间和住院时间]、术后病理结果、并发症发生情况和妊娠结局.结果 2组的肿瘤直径、缺血等级比较,差异均无统计学意义(P＞0.05);MILS组的扭转角度、手术时间、术中出血量、排气时间和住院时间分别为(436.0±189.0)°、(50.73±20.19)min、(18.84±5.42)mL、(16.48±7.08)h 和(5.23±1.32)d,均显著低于开腹组[(590.0±202.0)°、(69.41±25.63)min、(46.61±18.30)mL、(26.05±12.57)h 和(7.78±1.20)d],差异均有统计学意义(P＜0.05).妊娠早中期 BOTT患者病理检查结果可知:占比最高的是黄体囊肿,其次是成熟畸胎瘤和单纯性囊肿,2组的术后病理检查结果差异无统计学意义(P＞0.05).2组术后并发症发生率比较,差异无统计学意义(P＞0.05).2组的早产、流产、引产、分娩方式、分娩孕周和新生儿出生体重比较,差异均无统计学意义(P＞0.05).结论 MILS治疗妊娠早中期BOTT的术后并发症发生情况和妊娠结局与开腹手术治疗相当,但MILS手术效果优于开腹组.
Abstract
Objective To investigate the efficacy of multi-incision laparoscopic surgery(MILS)and open surgery in the treatment of early to mid-pregnancy ovarian benign tumors with torsion of the tumor pedicle(BOTT)and their impact on pregnancy outcomes.Methods A retrospective study was conducted on 92 pregnant women with early to mid-pregnancy BOTT who were admitted to Beijing Obstetrics and Gyne-cology Hospital,Capital Medical University,and the First Affiliated Hospital of Tsinghua University from February 2013 to January 2023.Based on the different surgical methods,the patients were divided into the open surgery group(n=40)and the MILS group(n=52).Perioperative indicators(including tumor diameter,torsion angle,ischemic grade,operation time,intraoperative blood loss,postoperative ventilation time,and length of hospital stay),postoperative pathological results,complications,and pregnancy outcomes were compared between the two groups.Results There were no statistically significant differences in tumor diameter and ischemic grade among the two groups(P＞0.05).The torsion angle,operation time,intraoperative blood loss,postoperative ventilation time,and length of hospital stay of MILS group were(436.0±189.0)°,(50.73±20.19)min,(18.84±5.42)mL,(16.48±7.08)h,and(5.23±1.32)d,respectively,which were much lower than those in the open surgery group[(590.0±202.0)°,(69.41±25.63)min,(46.61±18.30)mL,(26.05±12.57)h,and(7.78±1.20)d],the differences were statistically significant(P＜0.05).The pathological examination results showed that the highest proportion of cases was corpus luteum cyst,followed by mature teratoma and simple cyst,and there were no statistically significant differences in postoperative pathological results between the two groups(P＞0.05).The incidence of postoperative complications was not significantly different between the two groups(P＞0.05).There were no statistically significant differences in preterm delivery,miscarriage,induced abortion,mode of delivery,gestational weeks at delivery,and birth weight of newborns between the two groups(P＞0.05).Conclusion MILS is comparable to open surgery in terms of,in-cidence of postoperative complications,and pregnancy outcomes in the treatment of early to mid-pregnancy BOTT,but surgical efficacy is better than that of open surgery.
维普
万方数据