Đặc điểm lâm sàng, cận lâm sàng và xử trí u nhầy buồng trứng tại Bệnh viện Phụ sản Trung ương
Nội dung chính của bài viết
Tóm tắt
U nhầy buồng trứng đại diện cho một loạt các rối loạn tân sinh. U nhầy là loại u dễ tái phát và có khả năng biến chứng nguy hiểm nếu xử trí không đúng dù là lành tính. Nghiên cứu hồi cứu 240 hồ sơ bệnh án bệnh nhân u nhầy buồng trứng đã được phẫu thuật. Kết quả: 74,6% u nhầy lành tính, giáp biên 10,4%, ác tính 15,0%, tuổi ≥ 50 có tỷ lệ ác tính cao 25,0%. Triệu chứng đau bụng hay gặp 48,5%, bụng to lên nhanh và gầy sút cân là dấu hiệu gợi ý ác tính. Nếu U nhầy có đặc điểm: ở hai bên, kích thước từ 16 - 20cm, không di động, mật độ không đều, cứng chắc có tỷ lệ ác tính cao. Trên siêu âm hình ảnh âm vang hỗn hợp có tỷ lệ ác tính cao 63,0%. U nhầy lành tính có tỷ lệ mổ nội soi thành công cao 72,2%, u ác tính thường mổ mở 61,1%. Tỷ lệ bóc u 33,3%, cắt bỏ buồng trứng chung 66,3%. Kết quả điều trị tốt: 78,7%.
Chi tiết bài viết
Từ khóa
Từ khóa: U nhầy buồng trứng, Bệnh viện Phụ sản Trung ương, 2021
Tài liệu tham khảo
1. Coudane H, Goutallier D. Pathologie de la coiffe des rotateurs. In: Traité d’Appảeil Locomoteur. Elsevier. ; 1997.
2. Lafosse L, Jost B, Reiland Y, Audebert S, Toussaint B, Gobezie R. Structural integrity and clinical outcomes after arthroscopic repair of isolated subscapularis tears. J Bone Joint Surg Am. 2007;89(6):1184 - 1193. doi:10.2106/JBJS.F.00007
3. Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am. 2004;86(2):219 - 224. doi:10.2106/00004623 - 200402000 - 00002
4. Fealy S, Kingham TP, Altchek DW. Mini - open rotator cuff repair using a two - row fixation technique: outcomes analysis in patients with small, moderate, and large rotator cuff tears. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2002;18(6):665 - 670. doi:10.1053/jars.2002.32589
5. Lo IKY, Burkhart SS. Double - row arthroscopic rotator cuff repair: re - establishing the footprint of the rotator cuff. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2003;19(9):1035 - 1042. doi:10.1016/j.arthro.2003.09.036
6. Kirkley A, Griffin S, Dainty K. Scoring Systems for the Functional Assessment of the Shoulder. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2004;19:1109 - 1120. doi:10.1016/j.arthro.2003.10.030
7. Sugaya H, Maeda K, Matsuki K, Moriishi J. Repair integrity and functional outcome after arthroscopic double - row rotator cuff repair. A prospective outcome study. J Bone Joint Surg Am. 2007;89(5):953 - 960. doi:10.2106/JBJS.F.00512
8. Denard PJ, Jiwani AZ, Lädermann A, Burkhart SS. Long - term outcome of arthroscopic massive rotator cuff repair: the importance of double - row fixation. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2012;28(7):909 - 915. doi:10.1016/j.arthro.2011.12.007
9. Millett PJ, Warth RJ, Dornan GJ, Lee JT, Spiegl UJ. Clinical and structural outcomes after arthroscopic single - row versus double - row rotator cuff repair: a systematic review and meta - analysis of level I randomized clinical trials. J Shoulder Elbow Surg. 2014;23(4):586 - 597. doi:10.1016/j.jse.2013.10.006
10. Zwolak P, Meyer P, Molnar L, Kröber M. The functional outcome of arthroscopic rotator cuff repair with double - row knotless vs knot - tying anchors. Arch Orthop Trauma Surg. Published online August 25, 2020. doi:10.1007/s00402 - 020 - 03584 - 3
11. Abdelshahed M, Mahure SA, Kaplan DJ, et al. Arthroscopic Rotator Cuff Repair: Double - Row Transosseous Equivalent Suture Bridge Technique. Arthrosc Tech. 2016;5(6):e1297 - e1304. doi:10.1016/j.eats.2016.07.022
12. Ohzono H, Gotoh M, Nakamura H, et al. Effect of Preoperative Fatty Degeneration of the Rotator Cuff Muscles on the Clinical Outcome of Patients With Intact Tendons After Arthroscopic Rotator Cuff Repair of Large/Massive Cuff Tears. Am J Sports Med. 2017;45(13):2975 - 2981. doi:10.1177/0363546517724432
13. Burkhart SS, Barth JRH, Richards DP, Zlatkin MB, Larsen M. Arthroscopic repair of massive rotator cuff tears with stage 3 and 4 fatty degeneration. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2007;23(4):347 - 354. doi:10.1016/j.arthro.2006.12.012
14. Burkhart SS, Koo S. Large to massive rotator cuff tears. In: AANA Advanced Arthroscopy: The Shoulder. Saunders Elsevier; 2010:208 - 221.
15. Park J - Y, Lhee S - H, Choi J - H, Park H - K, Yu J - W, Seo J - B. Comparison of the clinical outcomes of single - and double - row repairs in rotator cuff tears. Am J Sports Med. 2008;36(7):1310 - 1316. doi:10.1177/0363546508315039
16. Fang J - H, Dai X - S, Yu X - N, et al. Lesions of the Long Head of the Biceps Tendon Concomitant with Rotator Cuff Tears: Tenotomy or Subpectoral Mini - open Tenodesis? A Comparative Short to Mid - term Follow - up Study. Orthop Surg. 2019;11(5):857 - 863. doi:10.1111/os.12536
17. Lee H - J, Jeong J - Y, Kim C - K, Kim Y - S. Surgical treatment of lesions of the long head of the biceps brachii tendon with rotator cuff tear: a prospective randomized clinical trial comparing the clinical results of tenotomy and tenodesis. J Shoulder Elbow Surg. 2016;25(7):1107 - 1114. doi:10.1016/j.jse.2016.02.006
2. Lafosse L, Jost B, Reiland Y, Audebert S, Toussaint B, Gobezie R. Structural integrity and clinical outcomes after arthroscopic repair of isolated subscapularis tears. J Bone Joint Surg Am. 2007;89(6):1184 - 1193. doi:10.2106/JBJS.F.00007
3. Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am. 2004;86(2):219 - 224. doi:10.2106/00004623 - 200402000 - 00002
4. Fealy S, Kingham TP, Altchek DW. Mini - open rotator cuff repair using a two - row fixation technique: outcomes analysis in patients with small, moderate, and large rotator cuff tears. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2002;18(6):665 - 670. doi:10.1053/jars.2002.32589
5. Lo IKY, Burkhart SS. Double - row arthroscopic rotator cuff repair: re - establishing the footprint of the rotator cuff. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2003;19(9):1035 - 1042. doi:10.1016/j.arthro.2003.09.036
6. Kirkley A, Griffin S, Dainty K. Scoring Systems for the Functional Assessment of the Shoulder. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2004;19:1109 - 1120. doi:10.1016/j.arthro.2003.10.030
7. Sugaya H, Maeda K, Matsuki K, Moriishi J. Repair integrity and functional outcome after arthroscopic double - row rotator cuff repair. A prospective outcome study. J Bone Joint Surg Am. 2007;89(5):953 - 960. doi:10.2106/JBJS.F.00512
8. Denard PJ, Jiwani AZ, Lädermann A, Burkhart SS. Long - term outcome of arthroscopic massive rotator cuff repair: the importance of double - row fixation. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2012;28(7):909 - 915. doi:10.1016/j.arthro.2011.12.007
9. Millett PJ, Warth RJ, Dornan GJ, Lee JT, Spiegl UJ. Clinical and structural outcomes after arthroscopic single - row versus double - row rotator cuff repair: a systematic review and meta - analysis of level I randomized clinical trials. J Shoulder Elbow Surg. 2014;23(4):586 - 597. doi:10.1016/j.jse.2013.10.006
10. Zwolak P, Meyer P, Molnar L, Kröber M. The functional outcome of arthroscopic rotator cuff repair with double - row knotless vs knot - tying anchors. Arch Orthop Trauma Surg. Published online August 25, 2020. doi:10.1007/s00402 - 020 - 03584 - 3
11. Abdelshahed M, Mahure SA, Kaplan DJ, et al. Arthroscopic Rotator Cuff Repair: Double - Row Transosseous Equivalent Suture Bridge Technique. Arthrosc Tech. 2016;5(6):e1297 - e1304. doi:10.1016/j.eats.2016.07.022
12. Ohzono H, Gotoh M, Nakamura H, et al. Effect of Preoperative Fatty Degeneration of the Rotator Cuff Muscles on the Clinical Outcome of Patients With Intact Tendons After Arthroscopic Rotator Cuff Repair of Large/Massive Cuff Tears. Am J Sports Med. 2017;45(13):2975 - 2981. doi:10.1177/0363546517724432
13. Burkhart SS, Barth JRH, Richards DP, Zlatkin MB, Larsen M. Arthroscopic repair of massive rotator cuff tears with stage 3 and 4 fatty degeneration. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2007;23(4):347 - 354. doi:10.1016/j.arthro.2006.12.012
14. Burkhart SS, Koo S. Large to massive rotator cuff tears. In: AANA Advanced Arthroscopy: The Shoulder. Saunders Elsevier; 2010:208 - 221.
15. Park J - Y, Lhee S - H, Choi J - H, Park H - K, Yu J - W, Seo J - B. Comparison of the clinical outcomes of single - and double - row repairs in rotator cuff tears. Am J Sports Med. 2008;36(7):1310 - 1316. doi:10.1177/0363546508315039
16. Fang J - H, Dai X - S, Yu X - N, et al. Lesions of the Long Head of the Biceps Tendon Concomitant with Rotator Cuff Tears: Tenotomy or Subpectoral Mini - open Tenodesis? A Comparative Short to Mid - term Follow - up Study. Orthop Surg. 2019;11(5):857 - 863. doi:10.1111/os.12536
17. Lee H - J, Jeong J - Y, Kim C - K, Kim Y - S. Surgical treatment of lesions of the long head of the biceps brachii tendon with rotator cuff tear: a prospective randomized clinical trial comparing the clinical results of tenotomy and tenodesis. J Shoulder Elbow Surg. 2016;25(7):1107 - 1114. doi:10.1016/j.jse.2016.02.006