腹腔镜辅助下阴式肌瘤剔除与子宫全切术128例

128 Cases of Laparoscopically Assisted Total Hysterectomy with Myomas Removed

目的 探讨腹腔镜辅助下施行肌瘤剔除与子宫全切术的安全性、可行性及临床价值。方法 对128例肌瘤、肌瘤肌病、功血患者施行腹腔镜下辅助阴式肌瘤剔除术与子宫全切的临床资料作回顾性分析。结果 128例病人全部经阴道手术成功，无1例中转开腹，无邻近脏器损伤，其中，完成子宫切除术52例，施行肌瘤剔除术76例，共剔除肌瘤486枚，手术时间平均68min（56～112min），术后经过均良好，胃肠功能恢复时间平均23h（11～35h），无1例感染，住院时间平均为7．1d（6～8d）。结论 腹腔镜辅助下阴式肌瘤剔除与子宫全切术损伤小，肠道干扰小，术后疼痛轻，康复快，体表不留瘢痕，是施行子宫全切与肌瘤剔除的安全、有效术式之一。

Objective To discuss safty, feasibility and clinical value of laparoscopically assisted total hysterectomy with myomas removed. Methods Retrospective research was carried out on 128 patients not suffering from prolapse of uterus, including gigantic uterus. Results 128 patients were successfully treated by transvaginal surgery, without anyone tranformed to ventrotomy, and any trauma of proximate organs, such as bladder, rectum, in which there were 52 cases of total hysterectomy, 76 cases of myoma removal with 486 myomas removed. The avarage time of surgion was 68 minutes（56 - 112 minutes）, that of gastrointestinal function was 23 hours（11-35 hours） ,that of hospitalization was 7.1 days（6 - 8 days）. Conclusion Laparoscopically assisted total hysterectomy with myomas removed is a safe and effective way of surgery, with less truma and gastrointestinal disturbance, tiny postoperative pain, quick recovery and no scar.