腹壁及会阴子宫内膜异位症病灶切除术术式改良

Modified Operation of Focal Excision for Endometriosis in Abdominal Wall or Perineum

目的改良腹壁及会阴子宫内膜异位症病灶切除术术式.方法改良一:于病灶表面原瘢痕处做一条形或梭形切口,切开皮肤达脂肪层后,适当游离形成皮瓣,皮瓣下适当保留部分脂肪组织,完整彻底切除病灶.改良二:不缝合皮下脂肪层之空腔,于腔内放置一橡皮片做引流,直接以0/4可吸收线连续皮内缝合皮肤层,于术后24～48h拔除橡皮引流片.结果会阴及腹部病灶切除共21例,术后1个月复查均无皮下硬结,伤口愈合良好、美观.结论改良后的子宫内膜异位症病灶切除术术式较传统术式更简单易行,瘢痕细小美观.

Objective To modify the operation of focal excision for endometriosis occurring in abdominal wall or perineum. Methods There are two approaches of modification. The first one was as follows ： a striped or fusiform incision which reached the underlying subcutaneous tissue was made on the original skin scar. Then skin flaps were developed, care being taken to preserve partial subcutaneous tissue beneath the skin, which was the most important step in avoiding skin necrosis. Next step was to remove the focus entirely and intactly. The second modification was： when the focus was removed there is a space between skin and the deep fascia, where a rubber tissue drain was placed. Then intradermal suture was performed for skin incision with 0/4 absorbable suture. The drain was removed after 24 -48 hours. Results None subcutaneous scleroma was found in the all 21 cases after 1 month of operation. All of skin incision recovered well and looked aesthetic. Conclusions The modified operation for endometriosis occurring in abdominal wall or perineum is simple to do. At the same time the scars is tiny and the incisions look aesthetic.