腹腔镜筋膜内子宫切除手术的安全性探讨(附60例临床分析)

Study on the classic intrafascial semm hysterectomy under laparoscope: 60 cases report

目的 探讨腹腔镜筋膜内子宫切除手术（CISH）的安全性及可能影响因素。方法 回顾分析腹腔镜筋膜内子宫切除手术60例。结果 手术时间100～330min，平均（179.5±53．4）min，出血100～600ml，平均（157．9±75．9）ml。在瘤体位置异常是造成出血量增多的显著因素（P〈0．01）。CISH手术中转开腹8例，主要原因为严重盆腔粘连和瘤体位置异常。结论 瘤体位置异常，严重盆腔粘连对CISH手术有明显的影响。必须注意关键环节的处理，可避免严重并发症的出现。

Objective To investigate the safety and potential affected factors of classic intrafascial Semm hysterectomy （CISH） under laparoscope. Methods A retrospective analysis was conducted in 60 women underwent CISH. Results The operative time was 100～330 min with the average of （179.5±53.4） min. The blood loss was 100～600 ml with the average of （157.9±75.9） ml. The blood loss was obviously more in the group of uncommon location of tumors than those in the common location （P〈0. 01）. Abdominal hysterectomy was performed in eight cases instead of CISH because of serious pelvic adhesion and uncommon location of tumors. Conclusions Uncommon location of tumors and severe pelvic adhesion are the major risk factors of the operations. Property arrangement of the crucial steps plays a role in avoiding the severe complications.