腹腔镜辅助腹壁小切口切除子宫肌瘤的体会

Study of laparoscopically assisted myomectomy and mini-laparotomy for myoma of uterus

目的:观察腹腔镜辅助腹壁小切口切除子宫肌壁间肌瘤的疗效。方法:对13例较大的子宫肌壁间肌瘤,于腹腔镜下剔除,经腹壁小切口缝合子宫切口,观察手术时间、术中出血量、术后并发症及术后恢复情况等,并随机抽取经腹切除子宫肌瘤21例,腹腔镜下切除子宫肌瘤19例作对照。结果:13例患者均不需中转开腹(大切口),平均手术时间为(102.53±10.87)m in,明显短于腹腔镜下子宫肌瘤切除术平均手术时间(158.2±13.74)m in(P<0.05);术中出血量为(50.82±2.16)m l,较经腹和单纯腹腔镜下切除明显减少(P<0.05),无发生术后出血、感染等并发症。结论:该术式既能达到开腹手术缝合子宫的质量标准,避免了腹腔镜下缝合子宫因操作困难、术中出血多、缝合不严密而造成术后出血、子宫裂开等弊端,又保留了腹腔镜下手术的所有优点,是一种操作简单、容易掌握、值得推广的技术。

Objective： To observe the clinical effects of laparoscopically assisted myomectomy and mini - laparo tomy for myoma of utencs. Methods： B selected patients uith uterine intuamural myoma were subjected to laparoscopically assisted myomectomy and mini -laparotomy technique. The duration of operation, blood loss, post - opwratin complications and time of full recovery were evaluated. Padomly selected 21 cases treated by laparoscopic operation and 19 cases treated by laparotomy operation as contrd groups. Results： The mean operation time in laparoscopically assisted myomectomy and mini - laparotomy lower than that in laparoscopic myomectomy gnwp （ P 〈 0. 05 ） . The blood loss in laparoscopically assisted myomectomy and mini -loparotomy gnwp was （50. 82 ± 2. 16） ml, significantly less then that in laparoscopic myomectomy group and laparotomy myomectomy group （P 〈 0. 05 ） . No complication such as post - operation bleeding and infection was observed. Conclusion： This technigue can achieve the quality requirement fou the uterine suture by caparotomy nvyomectomy, avoiding the possibility of post - operation bleeding and ruptwre of uterus due to the diffialhy in qutare ahile treated by caparoscopic surgery. This technique also has all the adlantages of laparoscopic surgery and is a simple and easy - to - perform technique.