腹腔镜下超大疑难子宫肌瘤切除术临床治疗探讨

Clinic investigation of large and complex myomeetomy by Iaparoscopy

目的 :研究腹腔镜下超大疑难子宫肌瘤切除术的临床可行性及安全性。方法 :将妇科自 2 0 0 1年 3月至 2 0 0 4年 6月治疗的子宫肌瘤患者共 2 18例 ,行腹腔镜下各种术式的子宫肌瘤切除术。其中超大疑难子宫肌瘤 17例 ,包括单发子宫肌瘤 9cm以上 ,宫底在脐下 2～ 3指 ,以及多发子宫肌瘤位于子宫颈、阔韧带和子宫峡部 ,至少 3个以上 ,肌瘤大小为 6～ 8cm者 ,均在腹腔镜下将超大特殊部位的肌瘤先核除 ,然后再行各种术式切除。结果 :所有手术均在腹腔镜下完成 ,其中LAVH3例 ,LSH9例 ,LM5例 ,无 1例发生并发症。结论 :腹腔镜下超大 ,疑难子宫肌瘤切除术是可行和安全的 ,但术者必须具备丰富的开腹手术经验 。

Objective: To investigate clinical flexibility and safety of complex laparoscopic myomectomy.Methods:218 cases from March 2001 to June 2004 were operated by all kinds of laparoscopic myomectomy. Results:All cases were completed with laparoscopy. LAVH 3 cases,9 cases by LSH and 5 cases were operated by LM. No case was suffered with complications.Conclusion:Large and complex laparoscopic myomectomy is safe and flexible.The operaters must master abundant and surgical expierence,also,experienced sewing-techonology.