腹腔镜与腹式横切口子宫肌瘤切除术近期临床效果对比

Comparison of clinical effect between laporoscopic and abdominal myomectomy with transverse incision

目的:比较腹腔镜与腹部横切口子宫肌瘤切除术的临床效果,分析腹腔镜下子宫肌瘤切除术转开腹的原因。方法:选择同期以子宫肌瘤为手术指征的要求保留子宫的病例共232例,随机分为两组,研究组行腹腔镜下子宫肌瘤切除术,对照组行腹部横切口开腹子宫肌瘤切除术。观察两组病例的手术时间、出血量、术后肠道功能恢复时间、术后平均住院日、发热及镇痛以比较两组治疗方法的优缺点。结果:研究组的术后平均住院日,术后发热,肠道功能恢复时间明显少于对照组,术后镇痛的病人数明显少于对照组。研究组手术时间较对照组长,而术中出血量两组比较无明显差异。研究组中有4例中转开腹的病例。结论:腹腔镜下子宫肌瘤切除术是一种安全、可行,具有良好应用前景的微创外科手术。我院在开展腔镜手术早期有中转开腹的病例,都是因为创面渗血、瘤体大、位置不佳、操作者技术不熟练而造成,随着技术的提高,中转开腹的病例不再发生。

Objective:To compare the clinical effect between laparoscopic and abdominal myomectomy with transverse incision and analyze the causes for myomectomy transverse incision from laporoscopic.Methods:232 patients with operative indications of hysteromyoma and having desire to preserve their uterus were averagely divided at random into study group (laparoscopic myomectomy) and control group (abdominal myomectomy with transverse incision).The operation parameters of the two groups were observed including operative time, intro-operative blood loss, recovery duration of gastrointestinal functian, the average hospitalization length, post-operative fever and analgesia to compare its relative merits.Results:The postoperative mean hospitalization length, fever, analgesia and recovery duration of gastrointstinal funotion was significantly less than those of control group (P<0.001).The mean operative time of study group was longer than that of control group (P<0.001).But there was no significant difference in blood loss between two groups.4 patients in study group transferred to accept abdominal myomectomy with transverse incision.Conclusion:Laparoscopic myomectomy is a safe, feasible and potential minimally invasive surgery.