腹腔镜与开腹子宫肌瘤剔除术的临床比较

Clinical comparison between laparoscopic myomectomy and abdominal myomectomy

目的评价应用腹腔镜与传统开腹方式进行子宫肌瘤剔除术的优缺点。方法回顾分析应用传统开腹手术方法52例和应用腹腔镜技术58例进行子宫肌瘤剔除术的临床资料,对手术时间、术中出血量以及术后恢复情况进行比较分析。结果腹腔镜手术术中出血量、术后肛门排气时间、术后病率和住院时间均明显低于开腹手术组,差异有显著性(P<0.01);但腹腔镜手术时间较开腹组长,住院费用高,差异有显著性(P<0.01)。结论腹腔镜下子宫肌瘤剔除术较传统开腹手术具有创伤小、恢复快,住院时间短,术中、术后并发症少等优点,但手术的实施对术者的技术水平和器械要求较高,尚不能完全取代开腹手术,合理选择术式是手术成功的关键。

Objective To evaluate advantages and shortages of laparoscopic myomectomy and abdominal myomectomy. Methods The length of operating time, bleeding volume during the operation, recovery condition after operation in 52 patients with abdominal myomectomy and 58 patients with laparoscopic myomectomy were retrospectively compared. Results Laparoscopic myomectomy is obviously superior to abdominal myomectomy for its less bleeding volume, short exhaust time, less incidence of complications and less hospitalization time （ P 〈0.01 ）. On the other hand, laparoscopic myomectomy also has obvious shortages when compared with abdominal myomectomy for its long operating time and high hospitalization cost （ P 〈 0.01 ）. Conclusion Laparoscopic myomectomy has advantages over abdominal myomectomy for its small wound, rapid recovery, less hospitalization time and less complications during and after operation. But it can not be substituted for abdominal myomectomy, because it needs higher professional skills of the operators and higher level of appliance. Choosing a reasonable operation type is the key to a successful operation.