TeamCirisano教学系列 - 卵巢肿瘤切除，皮样囊肿，畸胎瘤

TeamCirisano教学系列 - 卵巢肿瘤切除，皮样囊肿，畸胎瘤
TeamCirisano Teaching Series- Ovarian tumor removal dermoid cyst, teratoma

称为成熟性囊性畸胎瘤，皮样囊肿是卵巢肿瘤的外胚层，中胚层和内胚层起源。他们典型地包含成熟的组织和器官如皮肤，毛发，牙齿，皮脂腺，软骨，甲状腺组织。他们都充满了粘稠的，恶臭的粘液碎片。皮样囊肿发展的理论是失败的生殖细胞进行减数分裂II。皮样囊肿约占所有卵巢肿瘤的15％，而且几乎都是良性的。它们是最常见的卵巢肿瘤在妇女中的第二个和第三个十年的寿命。妇女与这些囊肿大部分是无症状的最初症状时，往往表现囊肿变大，足以造成显着的盆腔疼痛或不适。皮样囊肿超声上有一个经典的外观，呈现出复杂的质量与回声组成部分。但是，明确的诊断只能通过手术切除。本视频演示的过程中，一个大的皮样囊肿切除。腹腔镜有些人可能会被删除。与直径18厘米，在这种情况下，这的囊肿需要一个腹部切口。第一步是从周围的腹膜，分离出囊肿，收集腹腔冲洗分钟，以排除恶性肿瘤的机会。接下来的步骤是粘液性内容解压缩和漏极缓解拆除。如卵巢，输卵管，子宫，血液供应，和输尿管identifiy周边结构是很重要的。一个非常重要的结构是（IP）infundibulo盆腔的韧带，因为它包含了卵巢动脉和静脉。夹紧和连接的IP韧带是下一个步骤。最后的步骤是单独通过结扎子宫韧带从子宫囊肿。关键是要剥开皮样囊肿检查的内容，并送病理检查，以进一步排除任何机会的恶性。
The dermoid cyst, also known as mature cystic teratoma, is an ovarian tumor of ectodermal, mesodermal, and endodermal origin. They characteristically contain mature tissue and organ components such as skin, hair, teeth, sebaceous glands, cartilage, and thyroid tissue. They are filled with thick, sticky, foul-smelling mucinous debris. The theory of development of a dermoid cyst is failure of a germ cell to undergo Meiosis II.

Dermoid cysts represent approximately fifteen percent of all ovarian tumors, and are almost always benign. They are the most common ovarian tumor in women in the second and third decades of life. Most women with these cysts are asymptomatic initially, and symptoms often manifest when the cysts become large enough to cause significant pelvic pain or discomfort. Dermoid cysts have a classic appearance on ultrasound, showing a complex mass with echogenic components. However, definitive diagnosis can only be made by surgical excision.

This video demonstrates the process of removal of a large dermoid cyst. Some may be removed laparoscopically. In this case, with a diameter of eighteen centimeters, this cyst requires an abdominal incision. The first steps are to isolate the cyst from the surrounding peritoneum and collect peritoneal washings to rule out the minute chance of a malignancy. The next step is to decompress and drain the mucinous contents to ease the removal.

It is important to identifiy the surrounding structures such as the ovaries, fallopian tubes, uterus, the blood supplies, and the ureters. A very important structure is the infundibulo-pelvic (IP) ligament because it contains the ovarian artery and vein. Clamping and ligating the IP ligament is the next step. The final step is to seperate the cyst from the uterus by ligating the uterine ligament. It is crucial to cut open the dermoid cyst to inspect the contents, and send to pathology to further rule out any chance of malignancy.
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还是很不错的说