Clinical Efficacy And Prognostic Analysis Of Different Surgical Methods In The Treatment Of Ovarian Benign And Borderline Mucinous Tumors

Purpose The study aimed to compare the clinical data characteristics of patients with ovarian benign mucinous tumors and borderline mucinous tumors.Then,to evaluate the clinical effects of laparoscopic surgery and open surgery in the treatment of patients with benign and borderline mucinous tumors of the ovary.Finally,to analyze the risk factors for recurrence of benign and borderline mucinous tumors after surgery.Methods Patients who underwent surgical treatment in the Obstetrics and Gynecology Department of The First Afilliated Hospital of Fujian Medical University for ovarian mucinous tumors(benign or borderline mucinous tumors)form January 2013 to December 2019 were included in this retrospective study.According to the surgical pathway,patients were divided into the laparoscopic group(n=119)and the laparotomy group(n=68).The differences in the operation time,blood loss,postoperative hospital stay,postoperative complications and other indicators between the two groups were compared.Survival analysis was performed by Kaplan – Meier and Log-rank analysis.The risk factors for recurrence were analyzed using Multivariate Cox regression analysis.Results There were no statistically significant differences in age,BMI,HE4,AFP,menstruation,unilateral/bilateral,or the number of tumors in patients with borderline and benign ovarian mucinous tumors(P>0.05).The diameters of borderline ovarian mucinous tumors were longer than those of benign ovarian mucinous tumors(P<0.05).The results of CEA,CA125,CA199 for patients with borderline ovarian tumors were higher than those of patients with benign ovarian mucinous tumors(P < 0.05).Among the patients who underwent conservative surgery,the intraoperative blood loss in the laparoscopic group was less than that of the laparotomy group(P<0.05).Moreover,the postoperative hospital stay of the laparoscopic group was shorter than that of the laparotomy group(P < 0.05).Among the patients who underwent semi-radical surgery,the blood less in the laparoscopic group of was less than that of the laparotomy group(P < 0.05).Additionally,the postoperative hospital stay of the laparoscopic group was shorter than that of the laparotomy group(P<0.05).Among the patients who underwent radical surgery,the bleed loss,operation time,the postoperative hospital stay and postoperative complications in the laparoscopic group were less than those in the laparotomy group.All the differences were statistically significant(P<0.05).The postoperative follow-up time was 6-86 months.And the median follow-up time was 20.5(12-47)months.In the Kaplan-Meier survival curve analysis,patients who underwent conservative surgery had a shorter recurrence-free survival time than patients who underwent semi-radical surgery/radical surgery(Log-rak P=0.005).Multivariate Cox regression analysis showed that conservative surgery was the independent risk factor for the recurrence(HR=7.714,95%CI=1.331-44.694,P=0.023).Neither the Surgical pathway,tumor size,rupture of tumor,tumor involvement,number of tumors,pathological type,ascites,or purse-string suture was a risk factor for recurrence of tumor(P>0.05).Conclusions Compared with benign mucinous tumors,borderline mucinous tumors of the ovary have a larger diameter.Additionally,CEA,CA199,and CA125 in patients with borderline mucoinous tumors may be higher.Compared with semi-radical/radical surgery,conservative surgery has a higher risk of tumor recurrence.Laparoscopic surgery is a safe approach for ovarian mucinous benign and borderline tumors.The purse-string suture is safe in the operation of ovarian mucinous benign and borderline tumors.