日本産科婦人科内視鏡学会雑誌
Online ISSN : 1884-5746
Print ISSN : 1884-9938
原著論文
卵巣境界悪性腫瘍に対する腹腔鏡下手術と開腹手術の比較から推察される腹腔鏡下手術の利点と問題点
宇津 裕章金 美善西岡 嘉宏山下 剛
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ジャーナル フリー

2014 年 30 巻 1 号 p. 164-168

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Introduction: Borderline ovarian tumors (BOTs) account for 10-20% of ovarian epithelial tumors. Despite its moderate incidence and increase in laparoscopic surgery, the literature contains scant reports regarding the laparoscopic management of these tumors. This may be due to the difficulty in making a preoperative diagnosis.
Objectives and methods: This study was focused on investigating the characteristics of laparoscopic surgery for a BOT. We retrospectively reviewed the medical charts of 32 patients who were pathologically diagnosed with a BOT from April 2009 through March 2013. We compared age and observation period, tumor size, surgery time, amount of bleeding, length of hospital stay, frozen section, intraoperative tumor rupture, emergency surgery, fertility surgery, clinical stage, recurrence, and recurrence-free-survival (RFS) between 19 patients who underwent laparoscopy and 13 patients who underwent a laparotomy.
Results: The laparoscopic group had shorter hospital stays (4 days (range: 2-13) vs. 7 days (range: 6-19); P < 0.01), less frequent frozen section (2/19 (11%) vs. 7/13 (54%); P = 0.011), more frequent rupture (12/19 (63%) vs. 2/13 (15%; P = 0.009), fertility sparing surgery (13/19 (68%) vs. 1/13 (8%); P = 0.008) .
Conclusions: Laparoscopic surgery for a BOT should be performed with meticulous care in order to avoid rupture. However, laparoscopic surgery for a BOT appears to be safe since no significant difference in RFS between the two groups was found.
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