Prognosis Analysis Of Surgical Treatment Of Adnexal Masses During Pregnancy

Objective:To compare the effects of different surgical methods on the prognosis and pregnancy outcomes of adnexal masses during pregnancy.Meantime,to evaluate the safety and feasibility of gasless laparoscopic surgery with abdominal-wall lift method during pregnancy.Study design:A retrospective analysis of the clinical data of 30 patients who underwent surgery during the 12-16 weeks of pregnancy from December 2009 to December 2018 in our hospital.According to the different surgical methods,the patients were divided into two groups:the pneumoperitoneum group and the open group.The basic information of the two groups was calculated.Collect the patient's operating time,postoperative complications,postoperative pathology and other surgical information.The maternal and fetal pregnancy outcomes were followed up,and children's growth and development.The data were analyzed by IBM SPSS 23.0 statistical software.A probability value Of P<0.05 was considered statistically significant.Results:Conceptions occurred spontaneously in all women including a case of monochorionic-diamniotic twins.In the open group,the patients who underwent emergency surgery for abdominal pain were more than the patients without pneumoperitoneum.The elective surgery was less.There was no significant difference in the basic information between the two groups.The intraoperative blood loss was 33.75±24.73mL,the postoperative intestinal ventilation time was 1.56±0.40d,the postoperative hospital stay was 4.94±0.68d,and the postoperative 24h pain(VAS)score was 3.29±0.83.The intraoperative blood loss was 72.86±61.20mL,the postoperative intestinal ventilation time was 1.86±0.36d,the postoperative hospital stay was 6.71 ± 1.64d,and the postoperative 24h pain(VAS)score was 4.2510.68.The amount of bleeding in the middle group was lower than that in the open group.The postoperative ventilatory time and postoperative hospital stay were shorter than the open group.The 24h postoperative pain(VAS)score was lower than the open group.The difference between the two groups was statistically significant The operation time of the patients in the airless group was 102.38±47.17min,and the operation time in the open group was 71.43±31.71min.The operation time of the patients in the airless abdomen group was longer than that in the open group.The difference between the two groups was statistically significant.The surgical range selected by the two groups of patients was the same,and there was no significant difference in pelvic adhesions and accessory torsions found during the operation.The pathological results of all patients were positive.In terms of pathological diagnosis,mature cystic teratoma was the most,reaching 36.7%.Endometriosis cysts were most common in the abdomen-free group,and mature cystic teratomas were the most common in the open group.All patients had a smooth pregnancy until delivery,and there was no significant difference between the two groups in terms of pregnancy complications,maternal and fetal pregnancy outcomes,and child growth and development.Conclusion:gasless laparoscopic surgery during pregnancy is a safe and feasible alternative to open surgery.How to choose the two surgical methods,it is determined by patients and the surgeon's different requirements and skills.