Study On The Clinical Efficacy And Safety Of Laparoscopic Surgery On The Benign Ovarian Tumor

Background As one of the most common gynecological diseases, the incidence rate of benign ovarian tumor is very high. For the woman of birth requirement, the surgery should as far as reserved for patients with possible fertility based removing benign tumor. And for the infertile women, the surgery should as far as reduced the incidence of complications based removing benign tumor.Laparoscopic surgery has the characteristics of less blood loss, better recovery, remarkable effect has been widely recognized in clinical. With the development of technology and the maturity of the technology of laparoscopic operation, the scope of application of laparoscopic operation is more and more widely, has become the preferred method of treatment of ovarian benign tumor. This research adopts the laparoscopic treatment of 60 cases of benign ovarian tumor patients, and compared with laparotomy on 60 cases of benign ovarian, so as to provide the reference for the operation mode of patients with ovarian benign tumor.Objective 120 cases of benign ovarian tumor from 2012 February-2014 year in January in our hospital were selected as research object, age 26～56 years old, average (34.7+3.2), 31 cases of ovarian chocolate cyst,50 cases of teratoma,16 cases of ovarian serous cystadenoma,14 cases of ovarian coronal cyst,9 cases of mucinous cystadenoma. Using the random methods on all patients were divided into observation group and control group. The observation group 60 cases, age 26～56 years old, average (34.9+3.4),16 cases of ovarian chocolate cyst,24 cases of teratoma,9 cases of ovarian serous cystadenoma,7 cases of ovarian coronary cyst,4 cases of mucinous cystadenoma; control group 60 cases, age 25-55 years old, average (34.2+3.1), in 15 cases of ovarian chocolate cyst,26 cases of teratoma,7 cases of ovarian serous cystadenoma,7 cases of ovarian coronal cyst,5 cases of mucinous cystadenoma.To investigate the clinical effect and safety of laparoscopic and laparotomy of benign ovarian tumor, so as to provide the reference for the clinical treatment.Methods 120 cases of benign ovarian tumor patients were randomly divided into two groups,60 cases in each group. The patients in the two groups were treated by the laparoscopic surgery and the open surgery, respectively. Then the operation time, the blood loss, the hospitalization, the exhaustion time, the use of antibiotics in the two groups were compared and analyzed. And the incidence of complications including postoperative infection, organ injury, vascular injury and hernia were compared, too. WBC was counted by using SK8800 automatic blood cell analyzer, at the same time, record the neutrophil ratio.for the Determining serum immunoglobulin IgG, IgA and IgM levels, detecting of serum tumor necrosis factor (TNF-) and interleukin-6 (11-6) and high sensitive C-reactive protein (Hs-CRP) level all with HITACHI7170S automatic biochemical analyzerUsing HITACHI7170S automatic biochemical analyzer to determine serum immunoglobulin IgG, IgA and IgM level, at the same time detection of serum tumor necrosis factor (TNF-), interleukin 6 (II-6), and allergic C-reactive protein (Hs-CRP levelsResuts1.The observation group operation time was (60.4±12.2)min, the control group’s was (71.6±13.6) min, The observation group was obviously lower than that of control group, There was significant difference between two groups (P<0.05). The amount of bleeding in the operation of the observation group(71.5±22.1)mL were significantly lower than those in the control group (99.8±23.6) mL, and the differences were statically significant (P<0.05). The hospitalization time of the observation group(4.5±1.1)d were significantly lower than the control group (7.2±1.7) d, and the differences were statically significant (P<0.05)2.The observation group anal exhaust time is (1.24+0.37) d was significantly lower than that of the control group (2.51+0.39) d, there was significant difference between two groups (P<0.05). The observation group used antibiotic average time (3.17+1.15) mL was significantly lower than that of the control group (4.86+1.86) mL, there was significant difference between two groups (P<0.05)3.Only one patient in the observation group had been infected, the adverse reaction rate was 1.67%.In the control group, there were two patients had been infected, one patient had organ injury, three patients had vascular injury, one patient had hernia, the incidence of adverse reaction of 11.67%. The complication rate of observation group was 1.67%, significantly lower than the control group (P< 0.05)4.Compared the preoperative WBC level and neutrophils ratio of two groups, there was no statistically significant difference (P> 0.05). The WBC level and neutrophils ratio of postoperative 1 d,3d of observation group compared with preoperation’s, showed no statistical significance (P>0.05), Compared with preoperation, the WBC level and neutrophils ratio of postoperative 1 d,3d of control group, differences were statistically significant (P< 0.05). The observation group WBC levels and neutrophil ratio at 1D,3D after operation respectively was[(6.51±1.82)×1012L、(6.07±1.41)×1012L; (65.14±6.37)、 (61.54±6.07) significantly lower than the control group[(8.38±2.57)×1012L (7.29±1.78) ×1012L; (78.29±7.64)、(71.05±6.58), compared with control group, the difference had statistical significance (P< 0.05).5.Comparison of inflammatory factor Comparison of Preoperative serum TNF-a, IL-6 and Hs-CRP of two groups of no significant difference (P>0.05).Compared with pre-operation, the group 1dTNF-α, IL-6 and Hs-CRP had significant differences were observed after the operation (P<0.05), the 3dTNF-α, IL-6 and Hs-CRP showed no significant differences (P>0.05).Compared with before operation, at 1D after operation, the observation group TNF-a, IL-6 and Hs-CRP differences were statistically significant (P<0.05), the 3dTNF-α, IL-6 and Hs-CRP showed no significant differences (P>0.05).Conclusion Laparoscopic operation has the characteristics of small trauma, quick recovery, remarkable treatment effect,which has been widely recognized in clinical, with the laparoscopic technique and operation technologies mature, the scope of application of laparoscopic operation is more and more widely, which has become the preferred method of treatment of ovarian benign tumor. Laparoscopic operation incision is small,which can reduce the tissue damage and disturbance to the environment in the pelvic cavity, and reduce recovery and the amount of bleeding during and after operation for patients,and reduce patient pain for operation, and treatment effect is high security, it is worth in clinical application.