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| 題 名 | Combined Laparoscopy and Minilaparotomy in the Management of Stage Ⅲ and Ⅳ Endometriosis with an Endometrioma=第三及第四期子宮內膜異位症合併子宮內膜異位腫瘤之腹腔鏡及微小剖腹式手術治療 |
|---|---|
| 作 者 | 蔡育倫; 蕭國明; 黃建榮; 鄭偉吉; 莊盛全; | 書刊名 | 輔仁醫學期刊 |
| 卷 期 | 2:2 2004.06[民93.06] |
| 頁 次 | 頁55-61 |
| 分類號 | 417.27 |
| 關鍵詞 | 子宮內膜異位症; 子宮內膜異位腫瘤; 腹腔鏡; 微小剖腹式手術及懷孕; Endometriosis; Endometrioma; Laparoscopy; Minilaparotomy; Pregnancy; |
| 語 文 | 英文(English) |
| 中文摘要 | 目的:對於第三期及第四期子宮內膜異位症合併子宮內膜異位腫瘤接受腹腔鏡合併微小剖腹式手術治療方法及懷孕預後之評估。方法:本研究共有49位患有第三及第四期子宮內膜異位症合併子宮內膜異位腫瘤之女性。所有病人皆於1999年8月至2000年7月接受腹腔鏡併微小剖腹式手術。病患術前皆接受超音波診斷患有子宮內膜異位腫瘤,並測量腫瘤大小。手術前一週測量病患血中CA-125值。病患於術後追蹤懷孕之預後及疾病復發率,追蹤時間長達36個月之久。結果:有6位病患於術後無法追蹤(12.2%)。病患(共43個案)平均年齡為30.3±4.1歲,其血中平均CA-125值為72.3±67.7u/ml,並且有74.4%的腫瘤大於3公分。術後追蹤期內,所有病患接受了不孕症治療共123個週期。整體懷孕率為51.2%;12個月及24個月累積懷孕率各為32.5%及51.2%。腫瘤復發率為4.7%。結論:腹腔鏡合併微小剖腹式手術對於第三期及第四期子宮內膜異位症合併子宮內膜異位腫瘤的治療在追蹤了36個月後發現可以有效的減低復發率及具有與其他手術方式相同的懷孕率。 |
| 英文摘要 | Background and Purpose: We attempted to assess the technique and pregnancy outcomes of combined laparoscopy and minilaparotomy for stage Ⅲ and Ⅳ endometriosis with an endometrioma. Methods: In total, 49 patients with Stage Ⅲ or Ⅳ endometriosis with an endometrioma were examined in this study. All patients received treatment with combined laparoscopy and minilaparotomy between August 1999 and July 2000. Preoperative ultrasonography was performed to diagnose the endometrioma and measure the tumor size. The serum CA-125 level was checked 1 week before surgery. Patients were then inspected for pregnancy outcome and disease recurrence over a 36-month follow-up period. Results: Six patients were lost to follow-up after surgery (12.2%). The mean age of the patients (n=43) was 30.3±4.2 years. The mean serumCA-125 level was 72.3±67.7 U/ml, and 74.4% of the tumors were larger than 3 cm in diameter. In total, 123 cycles of controlled ovarian hyperstimulation were performed during the follow-up period. The overall pregnancy rate was 51.2% The cumulative pregnancy rates at 12 and 24 months were 32.5% and 51.2%, respectively. The recurrence rate of endometriomas was 4.7%. Conclusion: Combined laparoscopy and minilaparotomy for the management of stage Ⅲ and Ⅳ endometriosis with an endometrioma are effective with a low recurrence rate, and there may be a similar conception rate compared with other surgical techniques over a 36-month follow-up period. |
本系統中英文摘要資訊取自各篇刊載內容。