[Effects of virtual reality training on limb movement in children with spastic diplegia cerebral palsy].

OBJECTIVE: To study the effects of virtual reality (VR) training on the gross motor function of the lower limb and the fine motor function of the upper limb in children with spastic diplegia cerebral palsy. METHODS: Thirty-five children with spastic diplegia cerebral palsy were randomly assigned to VR training group (n=19) and conventional training group (n=16). The conventional training group received conventional physical therapy and occupational therapy for three months. The VR training group received VR training and occupational therapy for three months. Grip and visual-motor integration subtests in Peabody Developmental Motor Scales-2 were used to evaluate the fine movement in patients before and after treatment. The D and E domains of the 88-item version of the Gross Motor Function Measure (GMFM-88), Modified Ashworth Scale (MAS), and Berg Balance Scale (BBS) were used to evaluate the gross movement in patients before and after treatment. RESULTS: Before treatment, there were no significant differences in grip, visual-motor integration, fine motor development quotient, scores of D and E domains of GMFM-88, MAS score, or BBS score between the two groups (P>0.05). After treatment, all the indices were significantly improved in the VR training group compared with the conventional training group (P<0.05). CONCLUSIONS: VR training can effectively improve the gross motor function of the lower limb and the fine motor function of the upper limb in children with spastic diplegia cerebral palsy.

[Prospective study on magnetic resonance-guided focused ultrasound surgery for symptomatic uterine fibroid: short-term follow up].

OBJECTIVE: To evaluate the safety and efficacy of magnetic resonance-guided focused ultrasound surgery (MRgFUS) in treatment of symptomatic uterine leiomyoma among Chinese reproductive age women. METHODS: From April 2010 to April 2012, 80 premenopausal women with symptomatic leiomyoma volunteered to participate in this prospective study in Department of Outpatient of Peking Union Medical College Hospital. Among 23 reproductive aged patients with size of uterus less than 16th gestational weeks, 2.5 to 10 cm of diameter of myoma, less than 10 myomas and expressing symptoms clearly were treated by MRgFUS. Treatment data, non-perfused volume ratio (NPVR) and adverse events were recorded. After treatment, patients were followed up at 1 week, 1, 3, 6, 12 and 24 months, respectively. Patients at initial screening and each time of the follow-up filled out uterine fibroid symptoms quality of life (UFS-QOL), which include symptoms severity score (SSS) and health-related quality of life (HRQL). The volumes of leiomyoma and uterine were evaluated on MRI before and after the treatment (at 6 and 12 months, respectively). Before operation, routine blood test were performed on all patients, anemia patients at 3 months and 1 year after treatment were checked with blood test. RESULTS: (1) Treatment data and adverse events: the mean therapeutic temperature was (69 ± 7)°C, the mean treatment time was (144 ± 62) min, the mean NPVR was (62 ± 23)%. Adverse events included mild erythema(1/23), abdominal cramp (8/23), vaginal discharge (5/23), and leg numbness (4/23). (2) The rate of secondary surgery: one patient was treated by myoectomy and hysterectomy within one year following up and 4 patients chose surgical treatment during the second-year follow-up. (3) Volume change:the volumes of leiomyoma before the treatment and 6, 12 months after the treatment are 75.6(P25 = 43.8, P75 = 128.9), 52.3(P25 = 23.8, P75 = 111.2), 45.9(P25 = 26.3, P75 = 71.7) cm(3), respectively; and the volumes of uterine before the treatment and 6, 12 months after the treatment are 270.0 (P25 = 208.4, P75 = 390.3), 216.4 (P25 = 151.1, P75 = 290.0), 200.0 (P25 = 149.1, P75 = 267.6) cm(3), respectively. Both leiomyoma and uterine volumes decreased significantly after treatments (P < 0.01). (4) UFS-QOL change:the symptoms severity score (SSS) before the treatment and 3, 12 months after the treatment are (34 ± 13), (22 ± 11), (19 ± 12), which decreased significantly (P < 0.01). The health-related quality of life (HRQL) before the treatment and 3, 12 months after the treatment are (74 ± 15), (82 ± 13), (89 ± 10), which increased dramatically (P < 0.01). (5) Hemoglobin (HGB) change: eleven patients suffered from anemia before treatments, the mean HGB before treatment was (87 ± 6) g/L and were (106 ± 14) g/L 3 months after treatment, (112 ± 10) g/L 12 months after treatment. The HGB was increased significantly after treatments (P < 0.01). CONCLUSIONS: MRgFUS is a safe and effective non-invasive management for symptomatic uterine leiomyoma in short-term follow up. But there is additional treatment ratio after MRgFUS.

[Study on ischiospinous ligament fixation in treatment of stage III pelvic organ prolapse].

OBJECTIVE: To evaluate the safety and efficacy of ischiospinous ligament fixation in treatment of stage III pelvic organ prolapse (POP). METHODS: Between March 2007 and December 2009, 65 patients with stage III POP who underwent ischiospinous ligament fixation in Peking Union Medical College Hospital were enrolled in this study. Among 21 cases complicated with stress urinary incontinence (SUI) underwent transobturator tension-free vaginal tape (TVT-O) concomitantly. Clinical parameter associated with perioperation, objective and subjective successful rate and complication were recorded. RESULTS: The mean operating time was (71 ± 22) min and the mean blood loss was (93 ± 40) ml. No intraoperative blood transfusion and viscera injury cases were observed. All patients were able to recover spontaneous micturition. Two cases experienced pelvic hematoma with diameter of 7 cm, after conservative treatment, they all recovered later. The objective success rate was 100% at 6 weeks follow-up by POP-Q scoring. And 46.2% (30/65) were followed up at range of 1 - 3 years, recurrence rate were 10% (3/30), and however, no operation were needed. At median of 20 months, all patients were followed up by telephone, the subjective successful rate was 95.4% (62/65). At 6 weeks after operation, 6.2% (4/65) patients suffered from lower back pain and right thigh pain, visual analogue scale of pain was at range of 3 to 5, which relieved gradually after treatment and disappeared totally within 2 years. The rate of suture exposure was 10% (3/30), the new urinary incontinence 4.6% (3/65), and the new dyspareunia 12.5% (3/24). CONCLUSIONS: Ischiospinous ligament fixation is a safe and efficacious management.

[Prospective study on total pelvic reconstruction surgery with Prosima in the treatment of pelvic organ prolapse stage III].

OBJECTIVE: To evaluate the safety and efficacy of total pelvic reconstruction surgery with Prosima in treatment of pelvic organ prolapse (POP) stage III. METHODS: From July 2010 to December 2011, 31 patients with POP stage III undergoing total pelvic reconstruction surgery with Prosima were enrolled in this prospective study. Among two cases complicated with stress urinary incontinence underwent transobturator tension-free vaginal tape concomitantly with total pelvic reconstruction surgery with Prosima. Clinical parameters during peri-operation were recorded and compared. Pelvic organ prolapse quantitative examination (POP-Q) and anatomic improvement in these patients after surgery were analyzed. Comparisons of pelvic floor impact questionnaire-short form 7 (PFIQ-7) and pelvic organ prolapse-urinary incontinence sexual questionnaire-short form 12 (PISQ-12) in these patients before and after surgery were used to evaluate quality of life and quality of sexual life. RESULTS: The mean operating time was (55 ± 13) minutes, mean blood loss was (66 ± 25) ml. No severe intraoperative complications were observed. All patients were able to recover spontaneous micturation within 5 days. Two cases experienced pelvic hematoma with diameters less than 7 cm, and resolved later. Another case was urinary tract infection. At the median follow-up 6 months (1 - 15 months), the rate of anatomic success defined as the leading vaginal edge above the hymen was 94% (29/31). There were significant improvements in Aa, Ba, Ap, Bp, and C (P < 0.01) by POP-Q. Two patients showed recurrent prolapse at 3 months and 1 year after surgery, without the need of further operation. The median score of post-operative PFIQ-7 was 0 point at 6 months and 0 point at 12 months after operation, respectively, which were significantly lower than that of 50 points pre-operation (P < 0.01). And there was no significant difference in the average score of PISQ-12 before and after surgery [(30 ± 6) points versus (31 ± 4) points] (P > 0.05). The rate of mesh exposure was 16% (5/31), all the 5 cases occurred within 6 months and was cut in clinic. There was no case of de novo urinary incontinence and de novo dyspareunia. CONCLUSIONS: Pelvic reconstruction surgery with Prosima is safe and efficacy in treatment of POP stage III. It could improve quality of life remarkably without influence on sexual quality of life.

Total pelvic floor reconstruction surgery for repair of severe pelvic organ prolapse / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate clinical effectiveness of total pelvic floor reconstruction surgery for repair of severe pelvic organ prolapse.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 21 patients with severe pelvic organ prolapse. The anatomical outcomes were evaluated by Pelvic Organ Prolapse Quantitation, functional effectiveness by Prolapse Quality of Life method, and sexual function and operation-related complications were also analyzed.</p><p><b>RESULTS</b>All surgical operations were accomplished successfully by the same surgeon. No impairment of bladder, urethra, rectum, or great vessels was noted, and no patient required blood transfusion. The mean operation duration was (63±19) minutes, and the mean intra-operative blood loss was (143±72) ml. One patients experienced post-operative urinary retention for 7 days, and the remaining 20 patients were able to micturate spontaneously 1-2 day after surgery. The post-operative morbidity rate was 14.3%. Three patients (14.3%) experienced mesh erosion. Of 12 patients who were sexually active, two patients suffered from algopareunia from dyspareunia, one from de novo overactive bladder, and one from stress urinary incontinence Questionnaire scores showed that the overall post operative quality of life was improved significantly (P=0.000), while quality of sexual life significantly degraded (P=0.044) The anatomic cure rate was 95.2% (20/21), and the patient subjective satisfaction rate was 85.7% (18/21)</p><p><b>CONCLUSIONS</b>The total pelvic floor reconstruction is a safe and effective approach for the repair of severe pelvic organ prolapse, although its functional effectiveness is not as notable as anatomical outcomes However, the complications such as mesh erosion, low urinary tract symptoms, algopareunia, and dyspareunia should be carefully managed.</p>

Relationship between birth head circumference and adulthood quality of life in Chinese people.

AIM: To determine the relationship between birth size and later QOL for Chinese people. METHODS: Birth data of 1074 subjects were obtained from obstetric birth records of Peking Union Medical College Hospital. All subjects are interviewed face to face with the 36-Item Short-Form Health Survey scale by trained investigators. Linear regression model was used to analyse the relationship between QOL and birth head circumference of the subjects after adjusting for the childhood and adulthood characteristics. The relationship was described with regression coefficients (B) and its 95% confidence interval (CI). RESULTS: The mean weighted score of QOL was 88.1 ± 9.1, ranging from 76.8 to 100. Larger birth head circumference meant higher adulthood QOL total score (P= 0.001). After controlling the adulthood confounders, as compared to larger head circumference (≥33 cm), small (<31 cm) and medium head circumferences (31-33 cm) meant lower adulthood QOL scores (B=-2.356, P= 0.005 and B=-1.645, P= 0.014, respectively). The increase of head circumference by 1 cm was associated with 0.480 (95% CI: 0.141, 0.820) increase of QOL score after adjusting adulthood confounders (P= 0.006). CONCLUSIONS: This study validated the relationship between birth head circumference and QOL in later life. Smaller head circumference at birth could predict worse adulthood QOL at above 50 years old.

Low birth weight is associated with components of the metabolic syndrome.

The purpose of the study was to investigate the association between birth weight and number of metabolic syndrome (MetS) components in an urban Chinese cohort. Individuals (N = 2019) who were born between 1921 and 1954 at the Peking Union Medical College Hospital and who had detailed obstetric records volunteered to take part and were examined by medical personnel in a clinical setting between May 2003 and April 2005. Data of birth outcome and results on clinic examination in adulthood were analyzed using analysis of variance and multivariate ordinal regression to estimate the association between birth weight and MetS. Metabolic syndrome was defined as per the National Cholesterol Education Program Adult Treatment Panel III. The prevalence of MetS was 26.74%, whereas 55.43% of the subjects had at least 2 components of MetS. Subjects who presented with all 5 components of MetS exhibited a significantly lower birth weight and higher age, body mass index, and waist circumference at follow-up. Multivariate ordinal regression analysis revealed that, as compared with those with birth weights of 3000 to 3500 g, subjects who had birth weights of less than 2500 g were 66% more likely to develop a greater number of MetS components in adulthood (95% confidence interval, 1.18-2.34; P = .004), whereas those with birth weights between 2500 and 3000 g were 33% more likely to develop a greater number of MetS components as adults (95% confidence interval, 1.09-1.63; P = .005). The present study demonstrated the relationship between low birth weight and increased presentation of MetS components in Chinese adults.

[Total Prolift(TM) system surgery for the repair of recurrent severe pelvic organ prolapse].

OBJECTIVE: To evaluate the clinical outcomes of total Prolift(TM) system surgery for the repair of recurrent severe pelvic organ prolapse. METHODS: The clinical records of 13 cases of recurrent severe pelvic organ prolapse were retrospectively analyzed. The characteristic was vaginal vault prolapse in combination with anterior and posterior wall prolapse. Anatomic effect (according to POP-Q score), functional effect (according to prolapse quality of life) and sexual life (according to sexual life score) of each patient were assessed. All subjects were post-menopausal with a mean age (60 ± 9) years and a mean BMI of (25.6 ± 2.9) kg/m(2). RESULTS: All operations were accomplished successfully without any impairment of bladder, urethra, rectum, great vessels or nerves or blood transfusion. The mean operation time was (61 ± 18) minutes and the mean blood loss (155 ± 84) ml. All patients were followed up for a medium of 19 (15 - 30) months. Except for one post-operative urinary retention for a period of 7 days, 12 patients were able to micturate spontaneously 1 - 2 d post-operatively with a residual urine volume of less than 100 ml. During follow-up, mesh erosion (n = 1), de novo overactive bladder (n = 1), one algopareunia (n = 1) and dyspareunia (n = 1) occurred. Postoperative Quality of Life Scores improved significantly (P < 0.01). However, sexual life scores was impaired (P < 0.05). The anatomic cure rate was 92.3% and the patient subjective satisfactory rate 84.6%. CONCLUSION: The total Prolift(TM) system surgery represents a safe, simple and useful treatment for recurrent severe pelvic organ prolapse with satisfactory objective clinical outcomes. However, the level of patient subjective satisfaction is lower than objective cure rate. Meanwhile, harmful effects on sexual life remain a main concern.

Pregnancy outcomes of repeat cesarean section in Peking Union Medical College Hospital.

OBJECTIVE: To evaluate the effect of elective repeat cesarean section on the maternal and neonatal outcomes. METHODS: A retrospective clinic- and hospital-based survey was designed for comparing the maternal and neonatal outcomes of elective repeat cesarean section [RCS group (one previous cesarean section) and MRCS group (two or more previous cesarean sections)] and primary cesarean section (FCS group) at Peking Union Medical College Hospital from January 1998 to December 2007. RESULTS: The incidence of repeat cesarean section increased from 1.26% to 7.32%. The mean gestational age at delivery in RCS group (38.1+/-1.8 weeks) and MRCS group (37.3+/-2.5 weeks) were significantly shorter than that in FCS group (38.9+/-2.1 weeks, all P<0.01). The incidence of complication was 33.8% and 33.3% in RCS group and MRCS group respectively, and was significantly higher than that in FCS group (7.9%, P<0.05). Dense adhesion (13.5% vs. 0.4%, OR=7.156, 95% CI: 1.7-30.7, P<0.01) and uterine rupture (1.0% vs. 0, P<0.05) were commoner in RCS group compared with FCS group. Neonatal morbidity was similar among three groups (P>0.05). CONCLUSIONS: Repeat cesarean section is associated with more complicated surgery technique and increased frequency of maternal morbidity. However, the incidence of neonatal morbidity is similar to primary cesarean section.

Relationship between perinatal characteristics and later activities of daily living in Chinese elderly people.

BACKGROUND: There are no reports on the association between perinatal characteristics and comprehensive physical function in Chinese elderly people. In this study, we traced 875 subjects who were born at the Peking Union Medical College Hospital (PUMCH) of China from 1921 to 1941. The purpose of this study was to determine the effects of perinatal characteristics on activities of daily living (ADL) function in the geriatric period. METHODS: Birth data of 875 subjects were obtained from obstetric birth records of PUMCH. Adulthood data collection was conducted in the outpatient clinics of PUMCH. During the clinic visits, trained research staff administered physical examinations, activities of daily living scale and a demographic questionnaire. ADLs of all subjects were assessed with the activities of daily living scale. RESULTS: There were 101 subjects whose ADL function was limited and the rate of ADL limitation was 11.5%. Binary logistic regression analyses results showed that the main influencing factors of ADL were age, maternal age at birth, occupation, daily exercise and chronic disease. Subjects whose maternal age at their birth exceeded 35 years were at 2.202 times (1.188 - 4.083) greater risk of ADL limitation when we applied multivariate logistic regression models. CONCLUSIONS: This study validated the relationship between perinatal characteristics and ADL in the geriatric period. An older maternal age at birth could predict a higher ADL limitation rate in the geriatric period.

[Prevalence of human papillomavirus infection in women in Tibet Autonomous Region of China.].

OBJECTIVE: To determine the prevalence of cervical type-specific human papillomavirus (HPV) infection as well as risk factors associated in Tibet Autonomous Region of China. METHODS: A cluster sampling study was performed in Lasa, Rikaze and Naqu of Tibet. An epidemiological questionnaire was applied and 3036 cervical specimens were obtained for liquid-based cytology and HPV DNA detection. Statistical analysis included Wald Chi-square and stepwise logistic regression model. RESULTS: The overall HPV prevalence of involved 3036 women was 9.19% (279/3036), of which 7.05% (214/3036) of the women were infected by high-risk types (including 14 sorts of types) and 2.14% (65/3036) by low-risk types (including 6 sorts of types). There were no significant differences of HPV prevalence between age groups (P = 0.936), race (P = 0.718) and areas (P = 0.746), respectively. Twenty-one types of HPV were detected, of which HPV16 (1.52%) was the most common type, followed by HPV33 (1.42%), HPV58 (1.22%), HPV52 (1.15%), and HPV31 (1.05%). HPV type distribution was varied by age. Of the 279 HPV infected women, 14.3% (40/279) exhibited multiple HPV infections. Independent risk factors for HPV infection were smoking (P = 0.027), number of sex partners (P = 0.198) and early age of first intercourse (P = 0.237). CONCLUSION: The overall prevalence of HPV infection in Tibet Autonomous Region is lower than that in China or abroad, in which the most common genotype is HPV16 and the independent risk factors for HPV infection included early age of first intercourse, smoking, and number of sex partners.

[Effect of induction delivery on maternal-neonatal outcomes in 41 gestational weeks primiparae].

OBJECTIVE: To estimate the maternal-neonatal morbidity associated with induction deliveries compared with spontaneous deliveries in 41 gestational weeks uncomplicated primiparae. METHODS: Three hundred and seventy-four uncomplicated primiparous deliveries at 41 gestational weeks at Peking Union Medical College Hospital from Sept 2002 to Apr 2007 were reviewed, including 225 women undergoing induced labor and 149 women undergoing spontaneous labor. The induction methods included drug induction (173), rupture of membrane induction (5) and combined drug with rupture of membrane induction (47). The maternal morbidity, delivery method, maternal cost on hospital stay and neonatal asphyxia associated with induction deliveries or spontaneous deliveries were retrospectively analyzed. RESULTS: (1) There was no maternal death. The caesarean section rate in the induction group (44.0%, 99/225) was significantly higher than that of spontaneous group (18.1%, 27/149; P<0.05). (2) No statistically significant difference (P>0.05) was observed between induction group and spontaneous group in the following puerperal complications: postpartum hemorrhage (2.7%, 6/225 and 1.3%, 2/149 respectively), puerperal morbidity (0.9%, 2/225 and 0.7%, 1/149 respectively), severe amniotic fluid contamination (11.6%, 26/225 and 13.4%, 20/149 respectively), wound infection (0.9%, 2/225 and 0.7%, 1/149 respectively) ,urinary retention(4.4%, 10/225 and 3.4%, 5/149 respectively), traumata (0.4%, 1/225 and 0 respectively) and neonatal asphyxia (1.3%, 3/225 and 2.0%, 3/149 respectively). (3) The average duration of first stage of labor in the induction group (413 min) was not significantly different from that of spontaneous group (461 min; P>0.05). In the induction group, more women had precipitate labors (P<0.05) and the average duration of the second stage of labor was shorter than that of spontaneous group (40 min and 48 min, P<0.05). (4) Spontaneous group had shorter maternal hospital stay [(5.7 +/- 1.9) days vs (6.9 +/- 2.7) days, P<0.05] and caesarean section after induction had the highest hospital expense (P<0.05). CONCLUSIONS: Induction delivery at 41 weeks of gestation increases the rates of caesarean section, precipitate labor, clinical workload and hospital costs. Induction delivery as a prevention method of over due labor needs to be further discussed. Uncomplicated pregnancies of 41 weeks should be intentionally monitored if continued surveillance is possible. They should wait for spontanous delivery, and decision of induction should be made based on its benefit to the case.

[Clinical analysis of maternal and neonatal outcomes in uncomplicated term nulliparous after different routes of delivery].

OBJECTIVE: To compare maternal and neonatal outcomes after induction, elective cesarean section and spontaneous onset of labor in uncomplicated term nulliparous women. METHODS: A total of 3751 uncomplicated term nullipara who delivered in Peking Union Medical College Hospital from Sept 2002 to April 2007 were retrospectively analyzed. They were divided into three groups: the induction group, the elective cesarean section group, and the spontaneous onset of labor group. Their general conditions (such as age, weeks of pregnancy, hospital days and cost), postpartum complications (such as postpartum hemorrhage, puerperal morbidity, urinary retention, blood transfusion, delayed healing, and trauma), and Apgar score were compared by statistic methods. RESULTS: (1) Among 3751 women, 501 (13.3%) of them underwent induction( the induction group), 1634 (43.6%) delivered by cesarean section (cesarean section group), the other 1616 (43.1%) women underwent spontaneous onset of labor (the spontaneous onset of labor group). (2) Results of general conditions: the spontaneous onset of labor group had the shortest hospital days, which was longer in the induction group, and the longest in the selective cesarean section group (P < 0.01). The selective cesarean section group had the most cost during hospitalization, which was less in the induction group, and least in the spontaneous onset of labor group (P < 0.01). Women who undergwent emergent cesarean section after induction spent more money on hospitalization than those who were in the selective cesarean section group and the spontaneous onset of labor group (P < 0.01). (3) Puerperal complications: (1) postpartum hemorrhage: the incidence of postpartum hemorrhage was 3.0% (15/501) in the induction group, 0.6% (9/1634) in the selective cesarean section group and was 1.2% (19/1616) in the spontaneous onset of labor group (P < 0.01). (2 Urinary retention: the incidence of urinary retention was 4. 6% (23/501) in the induction group, 0 in the selective cesarean section group, and 3.3% (54/1616) in the spontaneous onset of labor group. So the rate of urinary retention was lower in the cesarean section group than in the other two groups (P < 0.01). (3) Blood transfusion: the incidence of blood transfusion in delivery was 2.0% (10/501) in the induction group, 0.1% (1/1634) in the selective cesarean section group, and 0.4% (6/1616) in the spontaneous onset of labor group (P < 0.01). (4) Trauma: the incidence of trauma in delivery was 0. 6% (3/501) in the induction group, 0 in the selective cesarean section group, and 0.4% (7/1616) in the spontaneous onset of labor group. So the rate of trauma was lower in the cesarean section group than in the other two groups (P < 0.01). (5) Delayed healing: the incidence of delayed healing of incision was 0.8% (4/501) in the induction group, 0 in the selective cesarean section group, and 0.2% (4/1616) in the spontaneous onset of labor group (P < 0.01). (6) Puerperal morbidity: there was no difference in puerperal morbidity among the three groups (P < 0.01). (7) Neonatal asphyxia: the incidence of neonatal asphyxia was 1.2% (6/501) in the induction group, 0.1% (1/1634) in the selective cesarean section group, and 1.0% (17/1616) in the spontaneous onset of labor group. The rate of neonatal asphyxia was lower in the cesarean section group than in the other two groups (P < 0.01). CONCLUSIONS: Induction may increase incidences of postpartum hemorrhage and blood transfusion, yet, it does not decrease the incidence of urinary retention and neonatal asphyxia. Generally, selective cesarean section is safer than induction and spontaneous onset of labor, but it costs most.

[Clinical aspects of mature ovarian teratoma: result of 695 cases].

OBJECTIVE: To evaluate the clinical aspects of mature ovarian teratoma. METHOD: We retrospectively studied 695 patients operated in PUMC Hospital between January 1990 and December 2000. RESULTS: Laparoscopy surgery had shorter hospitalization day, less blood loss during surgery, shorter operation time compared with laparotomy (P < 0.001). Routine contralateral wedge resection was done in 601 cases, among which 459 had normal inspection and palpatation. Only one (0.22%) was pathologically confirmed bilateral tumor. Torsion was the major complication (7.5%). Average tumor size of torsion was (10.2 +/- 4.5) cm. Probability of torsion increased as the tumor enlarged, which was less than 4.4% when the tumor size was less than 6 cm and greater than 10% if size greater than 8 cm. Rupture, infection, and malignant transformation were rare. CONCLUSIONS: Laparoscopy is superior to laparotomy in the treatment of mature ovarian teratoma. If the contralateral ovarian is within normal configuration, contralateral wedge resection is unnecessary. When the tumor size is greater than 8 cm in diameter, it will have more chance to twist.