文刚 诸建明 龚晟 李勇 乔键

[摘要] 目的 探讨经脐单部位腹腔镜辅助下治疗新生儿卵巢囊肿的优点及可行性。 方法 对2015 年 1 月～2016 年 12 月经脐单部位腹腔镜手术治疗的12例新生儿及小婴儿卵巢囊肿进行了回顾性总结。7例年龄小于1个月，5例年龄1～3个月；均为单侧，其中右侧9例，左侧3例；全部产前B超发现，均为单纯型。 结果 本组12 例患儿均经脐单部位腹腔镜辅助下完成卵巢囊肿剥除手术，手术过程顺利，无术中及术后并发症发生；手术时间45～65 min，平均55 min；术后恢复良好。 结论 经脐单部位腹腔镜辅助下治疗新生儿卵巢囊肿，技术要求简单，术中对腹腔干扰小，术后恢复快，切口美观；将腹腔镜技术和体表外科手术相结合，特别适用于新生儿及小婴儿卵巢囊肿。

[关键词] 单部位腹腔镜；卵巢囊肿；新生儿；临床研究

[中图分类号] R726 [文献标识码] B [文章编号] 1673-9701（2018）02-0062-04

[Abstract] Objective To investigate the advantages and feasibility of the treatment of neonatal ovarian cysts assisted by transumbilical single-incision laparoscopy. Methods The ovarian cysts in 12 newborns and infants who underwent transabdominal single incision laparoscopic surgery from January 2015 to December 2016 were retrospectively reviewed. 7 cases were less than 1 month old and 5 cases were from 1 to 3 months old. All of them were unilateral， with 9 on the right and 3 on the left， and all cases were found in prenatal B-mode ultrasonography and were simple type. Results All the 12 patients underwent transumbilical single incision laparoscopy to complete ovarian cyst extirpation. The procedure was successful. No intraoperative and postoperative complications occurred. The operative time was 45-65 minutes （average 55 minutes） and the patients recovered well after operation. Conclusion The treatment of neonatal ovarian cyst with transumbilical single incision laparoscopy has simple technical requirements， little intra-abdominal interference， rapid postoperative recovery and beautiful incision. The combination of laparoscopic surgery and body surface surgery is particularly suitable for newborns and small infants ovarian cysts.

[Key words] Single incision laparoscopy； Ovarian cysts； Neonate； Clinical study

新生儿病理性卵巢囊肿是指最大直径2 cm以上的囊肿[1]，为新生儿腹腔囊肿中最常见病因，其恶变率为20%～34%[1]。新生儿卵巢囊肿一般无临床症状，大多数患儿随着卵巢发育成熟，囊肿可自行消退。但是有的较大囊肿，会出现囊肿破裂、出血，压迫肠管出现呕吐、腹胀等消化道症状，甚至出现卵巢蒂扭转、坏死等严重并发症。因此，此类卵巢囊肿需要得到及时的处理。随着产前常规检查的普及及超声敏感性的提升，越来越多的卵巢囊肿在产前即被发现，新生儿期即得到相应处理。目前对于新生儿卵巢囊肿的治疗没有固定的方法，本文应用创伤小、恢复快的经脐单部位腹腔镜治疗新生儿卵巢囊肿，获得满意的临床疗效，现报道如下。……