经阴道子宫肌瘤剔除术25例报告

Clinical application of transvaginal myomectomy:Report of 25 cases

目的探讨经阴道子宫肌瘤剔除术的优点、可行性及临床疗效。方法对25例要求保留子宫的子宫肌瘤患者施行经阴道子宫肌瘤剔除术,观察其手术时间、术中出血、术后疼痛、肛门排气时间、术后病率及术后住院时间。结果25例行经阴道子宫肌瘤剔除术均成功,手术时间平均49.24±16.00 min,术中出血平均51.40±17.65 ml,术后无一例需要镇痛,术后病率为零,术后肛门排气时间平均25.56±5.45 h,术后住院时间平均4.00±0.76 d。原有症状均消失,复查B超未发现子宫肌瘤。结论经阴道子宫肌瘤剔除术具有创伤小、术后恢复快、腹壁无疤痕、费用低等优点,只要正确掌握手术适应证,这是一种安全可行的微创手术方法。

Objective To investigate the feasibility, safety and clinical efficacy of transvaginal myomectomy. Methods A total of 25 patients with uterine fibroids were treated with transvaginal myomectomy. Meanwhile, the complications of surgery, operating time, intraoperative blood loss, time to first passing flatus, incidence of postoperative pain, rate of postoperative pyrexia and length of postoperative hospital stay were explored. Results The transvaginal myomectomy was successfully completed without complication and postoperative disease in all the 25 patients. The operating time was 49.24± 16.00 min, the intraoperative blood loss was 51.40±17.65 ml, the time to first passing flatus was 25.56±5.45 h, the length of postoperative hospital stay was 4.00±0.76 d, and none of 25 patients asked for analgesic after operation. A follow-up was carried out for 13 months in 25 patients. The flow of menstrual cycle recoverd to normal levels, the pressure symptoms of adjacent organs disappeared, and no residual tumors were detected on B-ultrasonography in 25 patients. Conclusion The transvaginal myomectomy has advantages of little invasion, little interfering with abdominal organs, quick recovery, no scar in abdomen, low hospitalizing expense. It is a safe and feasible minimally invasive operation method when the indication of operation are managed properly.