Ovarian Transplantation and Ovarian Transplantation

Ovarian transplantation and ovarian transposition for the surgical treatment of ovarian tumors. With the advancement of science and technology, early diagnosis and early treatment of malignant tumors have become a reality, and the survival rate of patients has also been continuously improved. For example, the 5-year survival rate of stage Ia cervical cancer surgery has reached 87% to 92%. In the past, due to the fear of estrogen's cancer-promoting effect, there are few considerations for retaining ovarian function. In recent years, by studying the epidemiological investigation of cervical cancer patients and the determination of estrogen in blood, it is found that the occurrence and prognosis of cervical cancer may be high. Levels of estrone are related, so some scholars have suggested that patients with young cervical cancer or other gynecologic malignancies need to retain the ovaries. Since the 1980s, research on ovarian translocation and transplantation has been reported to preserve ovarian function not only to improve the quality of life of cancer patients, but also to improve prognosis. Treatment of diseases: adolescent and pediatric ovarian tumors, ovarian tumors Indication 1. Cervical cancer requires extensive hysterectomy in the early stage, and no metastasis of the ovary can be performed at the same time as surgery. 2. Endometrial cancer The ovary has no metastasis and one side of ovarian cancer and the contralateral ovary has no metastasis in young patients. 3. Factor uterine or ovarian tumors have undergone total uterine bilateral accessory resection, and severe endocrine disorders occur. Preoperative preparation 1. Detailed medical history before surgery, physical examination, attention to the breast and groin with or without mass. Do blood biochemical tests and endocrine function tests, such as follicle stimulating hormone (FSH), luteinizing hormone (LH), estrone (EI), estradiol (E2), progesterone (P). Measure basal body temperature, vaginal cytology, etc. 2. To determine the stage of disease and ovarian condition, a detailed gynecological examination, B-ultrasound, CT or MRI pelvic examination to exclude ovarian cancer metastasis. Surgical procedure Ovarian transplantation The surgery was performed in two groups. Abdominal surgery group laparoscopic operation steps are routinely performed to check whether the ovary is normal. If necessary, wedge-shaped resection of some ovarian tissue can be used for cryosection. After no cancer metastasis, one or both ovarian transplantation should be performed, and the ovarian intrinsic ligament and fallopian tube system should be cut first. Membrane, free ovarian arteriovenous, about 6 ~ 8cm in length. Pelvic lymph node dissection and extensive hysterectomy can be continued. In another group of ovarian transplantation, when the blood supply vessel was selected from the lateral arteriovenous wall of the chest wall, a longitudinal incision was made at the lateral line of the lateral iliac crest, which was about 6 to 7 cm long. The subcutaneous fat was separated from the pectoralis major muscle, and part of the muscle bundle was cut off. Find the lateral arteries and veins of the chest wall and free 3 to 4 cm. After ovarian vascular detachment, ovarian blood vessels were lavaged with 25 units of heparin saline per ml, and subcutaneously placed on the lateral side of the chest wall, and rubber drainage strips were placed and sutured to the skin layer by layer. For example, the blood supply vessels use the scapular movements and veins, and an arc-shaped incision is made under the armpits, and the ovarian implantation position is the same as before. 2. Ovarian transposition The free ovarian arteriovenous procedure is the same as the ovarian transplantation. The free length is about 8 ~ 12cm, and the skin is cut 1~2cm longitudinally under the anterior iliac crest of the ovary, and the length is about 2~3cm. The external oblique muscle fascia is cut, the internal and external oblique muscles are separated, and the peritoneum is cut. Or incision of the peritoneum from the ventral surface, the ovary is pulled out of the incision and fixed under the skin. At present, it is considered that this surgical method is simple, the ovarian survival rate is high, and the postoperative ovarian function recovery is fast, which is a surgical method worthy of advocating. complication Ovarian transplantation and ovarian transposition mainly include vasospasm, hemorrhage, coagulation, local compression and infection. Care should be taken to observe, disinfection, local exposure to infrared rays, application of drugs and antibiotics to prevent coagulation and infection.

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