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目的探讨腹腔镜下卵巢子宫内膜异位囊肿手术治疗效果。方法对2000年1月—2010年1月收治的148例卵巢子宫内膜异位囊肿患者进行回顾性分析。结果手术全部成功,无中转开腹。手术时间32～127min,平均68.6min。术中出血量30～450ml,平均85.3ml。住院天数3～9d,平均5.3d。单侧子宫内膜异位囊肿剔除81例,双侧32例,单侧附件切除加对侧囊肿剔除21例,全子宫加双侧附件切除14例。43例不孕症患者,输卵管单侧或双侧通畅36例(83.7%),伞端闭锁造口4例,双侧不通3例。R-AFS分期,Ⅰ期16例,Ⅱ期25例,Ⅲ期79例,Ⅳ期28例。复发率16.5%,远期并发症2.0%(3/148),痛经缓解总有效率63.6%(28/44),妊娠率41.9%(18/43)。结论腹腔镜手术创伤小、恢复快。治疗子宫内膜异位囊肿安全、有效,并且可以提高不孕症的妊娠率。
Objective To investigate the surgical treatment effect of laparoscopic ovarian endometriosis cyst. Methods A retrospective analysis of 148 patients with ovarian endometriosis admitted from January 2000 to January 2010 was performed. Results of all the successful surgery, no transit laparotomy. Surgery time 32 ~ 127min, an average of 68.6min. Intraoperative bleeding 30 ~ 450ml, an average of 85.3ml. Hospitalization days 3 ~ 9d, an average of 5.3d. Unilateral 81 cases of endometriotic cyst removed, bilateral in 32 cases, unilateral adnexal excision plus contralateral cyst removed in 21 cases, hysterectomy with bilateral attachment in 14 cases. 43 cases of infertility patients, tubal unilateral or bilateral unobstructed in 36 cases (83.7%), umbrella end of the stoma in 4 cases, bilateral unreasonable in 3 cases. R-AFS staging, stage Ⅰ in 16 cases, stage Ⅱ in 25 cases, stage Ⅲ in 79 cases, stage Ⅳ in 28 cases. Recurrence rate was 16.5%, long-term complications 2.0% (3/148), total effective rate of dysmenorrhea 63.6% (28/44), pregnancy rate 41.9% (18/43). Conclusions Laparoscopic surgery trauma is small, fast recovery. Treatment of endometriotic cysts is safe and effective, and can improve the pregnancy rate of infertility.