背景:在所有年龄组中,成熟的囊性畸胎瘤占良性卵巢肿瘤的近60%。我们的目标是更新现有的卵巢畸胎瘤的描述性研究,包括流行病学,扭转/恶性率,以及大型现代患者队列中的治疗方式。
方法:这是一项回顾性横断面研究,对2004-2015年在一家三级医疗机构接受手术的所有经病理证实的卵巢畸胎瘤病例进行了研究。患者人口统计学,卵巢囊肿的特点,手术方法和时机,溢出率,并检查手术并发症。
结果:在研究期间发现了1,054例卵巢畸胎瘤。双侧畸胎瘤113例(10.7%)。诊断时的平均年龄为38岁。平均囊肿大小为6.26cm。总扭转率为5.6%,随着囊肿大小的增加,扭转率更高。超过70%的病例接受了微创手术治疗,这与围手术期并发症减少相关,但囊肿溢出的风险增加。394例囊肿溢出患者中,只有一人出现化学性腹膜炎.该队列中成熟囊性畸胎瘤的恶性转化率为1.1%。该队列包括100名患有成熟畸胎瘤的孕妇。妊娠患者在妊娠早期更有可能进行微创手术,在妊娠中期或晚期更有可能进行剖腹手术。
结论:在这个大型现代群体中,我们发现了相似的双边率,扭转,恶性转化,与以前的文献相比,卵巢畸胎瘤和卵巢甲状腺肿。大多数卵巢畸胎瘤病例可以通过腹腔镜治疗,这与较低的手术并发症发生率有关。尽管微创方法增加了囊肿溢出的风险,化学性腹膜炎是一种罕见的并发症。
BACKGROUND: Mature cystic teratomas represent nearly 60% of benign ovarian neoplasms across all age groups.
OBJECTIVE: This study aimed to update existing descriptive studies of ovarian teratomas, including the epidemiology, rate of torsion or malignancy, and treatment modalities in a large modern cohort of patients.
METHODS: This was a retrospective cross-sectional study of all pathology-confirmed cases of ovarian teratoma that underwent surgery at 1 tertiary care institution from 2004 to 2015. Patient demographics, ovarian cyst characteristics, surgical approach and timing, rate of spillage, and surgical complications were examined.
RESULTS: A total of 1054 cases of ovarian teratoma were identified during the study period. There were 113 cases (10.7%) of bilateral teratoma. The mean age at diagnosis was 38 years. The average cyst size was 6.26 cm. The overall rate of torsion was 5.6%, with a higher rate of torsion with increasing cyst size. More than 70% of cases were treated with minimally invasive surgery, which was associated with decreased perioperative complications but an increased risk of cyst spillage. Among 394 patients with cyst spillage, only 1 patient developed chemical peritonitis. The malignant transformation rate of mature cystic teratoma in this cohort was 1.1%. This cohort included 100 pregnant women with mature teratoma. Pregnant patients were more likely to have minimally invasive surgery in the first trimester of pregnancy and more likely to undergo laparotomy in the second or third trimester of pregnancy.
CONCLUSIONS: Similar rates of bilaterality, torsion, malignant transformation, and struma ovarii in ovarian teratomas were found in this large modern cohort compared with previous literature. Most cases of ovarian teratoma can be managed laparoscopically, which is associated with a lower surgical complication rate. Despite the increased risk of cyst spillage with a minimally invasive approach, chemical peritonitis is a rare complication.