交界性卵巢肿瘤保留生育功能手术的临床研究

摘要

Objective: To retrospectively analyze the outcome of fertility-sparing surgery for borderline ovarian tumors, and compare ovarian function and disease prognosis between laparoscopy and laparotomy. Methods: The data of 52 patients with borderline ovarian tumor treated in our hospital from January 1 2008 to December 31 2013 were collected and divided into two groups according to surgical approach. There were 25 patients in laparoscopic surgical group and 27 patients in laparotomy group. The menstruation and fertility status before and after surgery,as well as postoperative recurrence were compared between the two groups. Results: Total postoperative pregnancy rate was 56. 5%. The laparoscopic postoperative pregnancy rate was significantly higher than laparotomy group (70. 8% vs. 40. 9%,P<0. 05). Total recurrence rate was 9. 6%,and the difference between two group was not significant ( P>0. 05 ) . However, the laparoscopic group had less intraoperative hemorrhage [(342. 0±60. 9) ml vs. (422. 0±69. 8) ml,P<0. 05],shorter operation time [(222. 0± 11. 9) min vs. (245. 0±12. 8) min,P<0. 05],more rapid recovery of gastrointestinal function [(26. 3±7. 5) hours vs. (41. 6±6. 4) hours,P<0. 05],less infection (8. 0% vs. 29. 6%,P<0. 05),shorter length of hospital stay [(7. 2±0. 5) days vs. (7. 9±1. 0) days,P<0. 05]. Conclusions: In the fertility-sparing surgery for borderline ovarian tumors, laparoscopic surgery and traditional laparotomy surgery have similar efficacy and safety. However, the laparoscopic surgery has less intraoperative hemorrhage and postoperative complications,shorter hospitalization time and quicker recovery. It is more important that the fertility of borderline ovarian cancer patients can be better preserved by laparoscopic surgery.%目的：回顾性分析交界性卵巢肿瘤保留生育功能手术,比较腹腔镜手术与开腹手术对卵巢生育功能及疾病预后的影响。方法收集襄阳市中心医院2008年1月1日至2013年12月31日予保留生育功能手术治疗的交界性卵巢肿瘤患者52例,分为开腹组27例、腹腔镜组25例。比较两组患者手术前后月经及生育情况、术后复发情况。结果术后总妊娠率56．5%,腹腔镜组高于开腹组(70．8% vs．40．9%,P<0．05)；总体复发率9．6%,两组差异无统计学意义(P>0．05)。但是与开腹手术组相比,腹腔镜组术中出血量少[(342．0±60．9) vs．(422．0±69．8) ml,P<0．05)]、手术时间短[(222．0±11．9)vs．(245．9±12．8) min,P<0．05]、术后胃肠道功能恢复快[(26．3±7．5)vs．(41．6±6．4) h,P<0．05]、合并感染少(8．0% vs．29．6%,P<0．05)、住院时间短[(7．2±0．5)vs．(7．9±1．0) d,P<0．05]。结论在交界性卵巢肿瘤保留生育功能手术中,腹腔镜手术与传统开腹手术相比具有同样的有效性和安全性,但腹腔镜手术术中出血量及术后并发症少、住院时间短、术后患者恢复快,更重要的是能更好的保留交界性卵巢肿瘤患者的生育力。