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首页> 外文期刊>Surgical Endoscopy >Laparoscopic management of tubo-ovarian abscesses: retrospective analysis of 60 cases.
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Laparoscopic management of tubo-ovarian abscesses: retrospective analysis of 60 cases.

机译：腹腔镜治疗输卵管卵巢脓肿：回顾性分析60例。

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BACKGROUND: The laparoscopic management of tubo-ovarian abscesses (TOA) was evaluated. The study sought to answer the following question: Does operative laparoscopy with only incision of the abscess cavity and lavage (organ-preserving treatment) improve intraoperative and postoperative safety and long-term prospects of fertility as compared with laparoscopic salpingectomy or salpingo-oophorectomy (ablative treatment)? METHODS: A retrospective chart review of 60 patients with TOA undergoing laparoscopic treatment in combination with broad-spectrum antibiotics from 1994 to 1998 was performed. Patients not wishing to have children underwent salpingectomy or salpingo-oophorectomy, whereas patients wishing to remain fertile were treated by means of an organ-preserving procedure. To investigate the operative and reproductive outcome, patients were interviewed by telephone. RESULTS: Of 60 women with TOA, 25 were treated laparoscopically, preserving the internal genital organs, and 35 underwent ablative treatment. Apart from one postoperative readmission because of lower pelvic pain in the organ-preserving group, there were no operative complications or serious systemic sequelae. In contrast, there was a significantly higher incidence of intraoperative and postoperative complications when ablative treatment was performed: one intestinal perforation requiring subsequent laparotomy, four serosal lesions, two lesions of the greater omentum, two lacerated collaterals of the internal iliac artery, one postoperative fever higher than 38 degrees C for 2 days, two bowel obstructions, one thrombosis of the upper leg, and one thrombosis of the lower leg. There were no significant differences between the two patient groups in body mass index, duration of pelvic pain, laboratory findings at admission, ultrasonic assessment of abscess size, and the extent of the abscess at laparoscopy. CONCLUSIONS: When laparoscopic treatment of TOA is performed, organ-preserving treatment should be chosen irrespective of the patient's age or desire to have children because of the risk of complications.
机译：背景：腹腔镜治疗大卵巢卵巢脓肿（TOA）的评估。该研究试图回答以下问题：与腹腔镜输卵管切除术或输卵管卵巢切除术（消融术）相比，仅切开脓肿腔和灌洗的手术腹腔镜检查（保留器官的治疗）是否能改善术中和术后安全性以及长期生育前景？治疗）？方法：回顾性分析了1994年至1998年接受腹腔镜联合广谱抗生素治疗的TOA患者60例。不希望生孩子的患者接受输卵管切除术或输卵管卵巢切除术，而希望保持生育能力的患者则通过保留器官的方法进行治疗。为了调查手术和生殖结果，通过电话采访了患者。结果：在60名TOA妇女中，有25名接受了腹腔镜治疗，保留了内部生殖器官，其中35名接受了消融治疗。保留器官的患者除因盆腔疼痛引起的一次术后再入院外，没有手术并发症或严重的系统后遗症。相反，进行消融治疗时，术中和术后并发症的发生率显着较高：一个肠穿孔需要随后的剖腹手术，四个浆膜病变，两个大网膜病变，两个internal内动脉撕裂侧支，一个术后发烧高于38°C的情况持续2天，出现两个肠梗阻，一次大腿血栓形成，一次小腿血栓形成。两组患者的体重指数，骨盆疼痛持续时间，入院时的实验室检查结果，超声检查脓肿大小以及腹腔镜检查脓肿的程度均无显着差异。结论：腹腔镜手术治疗TOA时，应考虑保留器官的治疗方法，而不论患者的年龄或有生育的意愿，因为存在并发症的风险。

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