Laparoscopic management of ovarian dermoid cysts:: a review of 47 cases
Laparoscopic management of ovarian dermoid cysts:: a review of 47 cases
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DOI：
10.5144/0256-4947.2004.357
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发表时间：
2004-09-01
影响因子：
1.6
通讯作者：
Haberal, A
中科院分区：
文献类型：
--
作者：
Koçak, MK;Dilbaz, B;Haberal, A
背景：成熟的囊性畸胎瘤，通常被称为皮样囊肿，是最常见的卵巢生殖细胞肿瘤。近年来，经阴道超声诊断卵巢皮样囊肿，结合腹腔镜手术，大大提高了卵巢皮样囊肿的治疗水平。我们回顾性分析了2000年1月至2003年5月期间行腹腔镜手术治疗卵巢皮样囊肿的患者的术前表现、手术技术和术后并发症。结果：在47名年龄为21至53岁（中位数，38.8岁）的女性中，93.6%的单侧囊肿直径为17至108 mm（中位数，51 mm）。临床表现为疼痛（62%），阴道异常出血（21%）和卵巢扭转（2%），而17%的诊断是偶然在常规检查。手术包括卵巢切除术（57%）、全卵巢切除术（36%）或部分卵巢切除术（6.4%）和腹腔镜辅助阴式子宫切除术联合双侧输卵管卵巢切除术（2%）。在囊肿摘除过程中，42.5%的病例发生了轻微的溢出，没有发生化学性腹膜炎。在2例患者中，需要中转开腹手术（4.3%），1例因乙状结肠损伤，1例因冷冻切片检测到的恶性卵巢肿瘤。中位手术时间为80分钟（范围，35-180分钟）。结论：严格遵守术前临床评估和术中管理指南，腹腔镜治疗皮样囊肿似乎是一个安全的程序。
Background: Mature cystic teratomas, often referred to as dermoid cysts, are the most common germ cell tumors of the ovary. In the recent years, transvaginal sonographic diagnosis of ovarian dermoid cysts together with laparoscopic approach have greatly improved the treatment of this benign lesion. We retrospectively reviewed the outcome of laparoscopic surgery for suspected ovarian dermoid cysts.Patients and Methods: The preoperative findings, operative techniques and postoperative complications were retrospectively reviewed in women who underwent laparoscopic surgery for dermoid cysts, between January 2000 and May 2003.Results: In 47 women aged 21 to 53 years (median, 38.8 years), 93.6% had a unilateral cyst with a diameter of 17 to 108 mm (median, 51 mm). Clinical presentations were pain (62%), abnormal vaginal bleeding (21%) and ovarian torsion (2%), whilst 17% were diagnosed incidentally during routine examination. Surgery included cystectomy (57%), total (36%) or partial oophorectomy (6.4%) and laparoscopy-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy (2%). During the cyst extraction, minimal spillage occurred in 42.5% of the cases and none developed chemical peritonitis. In 2 patients, conversion to laparotomy (4.3%) was required, one for sigmoid colon injury and one for malignant ovarian tumor detected via frozen section. The median operating time was 80 minutes (range, 35-180 minutes).Conclusion: Using strict adherence to guidelines for preoperative clinical assessment and intra-operative management, laparoscopic treatment of dermoid cysts appears to be a safe procedure.