腹腔镜下筋膜内巨大子宫切除39例分析

Analysis on classical intrafascial supracervical hysterectomy of gigantic uterus under laparoscope (report of 39 cases)

目的：探讨腹腔镜下筋膜内巨大子宫切除术的安全性和临床应用价值。方法：对39例子宫大小超过12孕周的患者行腹腔镜下筋膜内子宫切除术（CISH），并对其临床资料进行回顾性分析，包括手术时间、子宫重量、术中出血量及并发症。结果：所有手术均在腹腔镜下完成，无1例中转开腹，平均手术时间107min（56—149min），切除子宫的平均重量659g（306-1730g），术中平均出血128ml（50～520m1），有l例术中出血超过500ml，经适当处理后，预后良好，无其他手术并发症发生。结论：腹腔镜下筋膜内巨大子宫切除术是安全可行的，但术者必须熟练掌握手术技巧。

Objective： To investigate the safety and clinical value of classical intrafascial supracervical hysterectomy （CISH） of gigantic uterus under laparoscopy. Methods： The uteris of thirty -nine cases larger than 12 -week pregnant uteri accepted CISH to retrospectively analyze the data involved the operating time, weight of the uterus, blood loss during operation and complications. Results： All opera- tions were performed successfully under laparosopy. The average operating time was 107 （56- 149） min, the weight of the uterus was 659 （306 - 1 730） g, blood loss in operation was 128 （50 -520） ml, only one of them was above 500 ml and it was recovered well after proper management. No other complications happened. Conclusion： Laparoscopic CISH of gigantic uterus is safe and feasible, but operators must grasp operating techniques skillfully.