单孔腹腔镜手术治疗儿童卵巢囊肿蒂扭转临床分析

Clinical analysis of single-port laparoscopic surgery in the treatment of ovarian cysts pedicle torsion in children

关键词:  腹腔镜检查  单孔  卵巢囊肿  蒂扭转  儿童

Key words:  laparoscopy  single-port  ovarian cysts  pedicle torsion  child

摘要:

目的　探讨单孔腹腔镜手术治疗儿童卵巢囊肿蒂扭转的临床价值。方法　回顾性分析大连市儿童医院2016年1月至2018年10月采用单孔腹腔镜行卵巢囊肿蒂扭转复位腹腔外囊肿剥除术22例的临床资料，其中左侧10例，右侧12例；年龄4～14岁［（10.2±2.9）岁］；体重指数13～23 kg/m²［（17.7±2.9）kg/ m²］；患儿均接受3～36个月的随访。观察患者的手术和术后情况。结果　22例患儿均顺利完成手术，无中转开腹及多孔腹腔镜手术。手术时间25～60 min［（41.4±9.2）min］，囊肿直径5～16 cm［（8.4±2.7）cm］，术中出血量5～20 mL［（11.4±3.5）mL］。患儿术后肠蠕动恢复时间8～20 h［（13.6±3.7）h］，术后住院时间3～6 d［（4.2±0.9）d］，住院治疗期间无手术相关并发症。21例扭转的卵巢囊肿复位后剥除囊肿保留卵巢组织，1例因卵巢及输卵管已缺血坏死，切除病变附件。手术切除的组织病理诊断均为良性病变。患儿术后随访3～36个月，彩色多普勒超声检查无卵巢萎缩及囊肿复发病例。结论　单孔腹腔镜手术治疗小儿卵巢囊肿蒂扭转操作简单，损伤小、恢复快、瘢痕不明显、手术确切可靠，该技术值得推广应用。

Abstract:

Objective　To investigate the clinical value of single-port laparoscopic surgery in the treatment of ovarian cysts pedicle torsion in children. Methods　The clinical data of 22 children with ovarian cysts pedicle torsion, who underwent single-port laparoscopic surgery from during January 2016 and October 2018, were retrospectively analyzed. The children of 4-14 years old［mean (10.2±2.9) years old］ were included in the study, of whom 10 cases were on the left and 12 on the right. Body mass index (BMI) was 13-23 kg/m² with a mean value of (17.7±2.9) kg/m². All patients were followed up for 3-36 months. The clinical data including operative situations, postoperative situations and perioperative period were analyzed statistically. Results　All procedures were successfully completed without conversion to open surgery or mult-port laparoscopic surgery in 22 patients. Operation time was 25-60 min with a mean value of (41.4±9.2) min; diameter of the ovarian cysts was 5-16 cm with a mean value of (8.4±2.7) cm; intraoperative blood loss was 5-20 mL with a mean value of (11.4±3.5) mL. The bowel movement was recovered at 8-20 h［(13.6±3.7)］ h after surgery; postoperative hospital stay was 3-6 d with a mean value of (4.2±0.9) d. There were no complications during treatment. Twenty-one patients who received surgery had their ovaries preserved, 1 patient underwent adnexectomy due to necrosis of oviduct and ovary. All children were confirmed to have benign ovarian cysts by pathological examination. The patients were followed up for 3-36 months, and the Color Doppler ultrasound showed no recurrence or atrophy of ovaries after surgery. Conclusions　Single-port laparoscopic surgery in the treatment of children ovarian cysts pedicle torsion is easy, minimally invasive, quickly recovered, and reliable without obvious scar. It is worth further clinical application.