腹腔镜下保留生育功能手术治疗早期卵巢交界性肿瘤的临床研究

摘要

Objective To investigate the clinical efficacy of laparoscopic fertility-sparing surgery for patients with early-stage borderline ovarian tumors (BOTs).Methods We retrospectively analyzed 143 patients with BOTs in our hospital from January 2010 to December 2011.Of these patients,87 patients were treated with laparoscopic fertility-sparing surgery while other 56 patients were treated with transabdominal surgery.A series of data including intraoperative and postoperative indexes,fertility status and recurrence rates were compared between the two groups.Results The laparoscopic group had less operation time,less intraoperative blood loss,less analgesia use,quicker recovery of bowel function,shorter hospital stay and fewer complications than those in the laparotomy group (P ＜ 0.05).The postoperative fertility rate in the laparoscopic group was significantly higher than that in the laparotomy group (P ＜ 0.05).There was no significant difference in the recurrence rate between the two groups after 5-year follow-up (P ＞ 0.05).Conclusion Compared with laparotomy surgery,laparoscopic fertility-sparing surgery has not only obvious advantages such as less iatrogenic injury,less bleeding,less complications and quick recovery,but also does not increase the recurrence rate.The laparoscopic surgery is more effectively on conserving the fertility of patients with BOTs.It is worthwhile for spreading in clinical practice.%目的 探讨腹腔镜下保留生育功能手术治疗早期卵巢交界性肿瘤的临床疗效与应用价值.方法 2010年1月至2011年12月于四川大学华西第二医院收治的143例要求保留生育功能的早期卵巢交界性肿瘤患者,其中腹腔镜手术87例,开腹手术56例,对比分析两组患者术中术后情况、生育情况及复发情况.结果 腹腔镜组患者的手术时间、术中出血量、术后镇痛药物使用率、肛门排气时间、术后住院时间及术后并发症发生率均明显少于开腹组,差异有统计学意义(P＜0.05).腹腔镜组患者术后5年妊娠率明显高于开腹组(P＜0.05).两组患者肿瘤复发率差异无统计学意义(P＞0.05).结论 与开腹手术相比,腹腔镜下保留生育功能手术治疗早期卵巢交界性肿瘤具有手术创伤小、术中出血少、术后并发症少、恢复快等优势,且不增加术后复发率,更重要的是,对于生育能力的保留显著优于开腹手术,值得临床推广.