妇科阴式子宫附件手术转开腹原因分析

Clinical analysis of the causes of gynecological vaginal uterine appendage surgery referred to laparotomy

目的:探讨妇科阴式子宫附件手术转开腹原因。方法:回顾分析我院2002年3月～2008年3月接受阴式子宫附件手术2 657例中31例转开腹手术的原因。结果:转开腹率为1.17%(31/2 657),其中术中开腹23例,术后因各种并发症开腹8例。转开腹手术主要原因为手术并发症45.16%(14/31),盆腔粘连38.7%(12/31),病变部位特殊8.67%(3/31),盆腔恶性肿瘤6.45%(2/31)。结论:妇科阴式子宫附件手术转开腹原因依次为:手术并发症、盆腔粘连、病变部位特殊、盆腔恶性肿瘤。适时的术中术后转开腹有利于减少或避免并发症的发生。

Objective：To investigate the causes of gynecological vaginal uterine appendage surgery referred to laparotomy and its preventive measures.Methods：The causes in 31 cases referred to laparotomy from 2657 cases undergoing vaginal uterine appendage surgery from March 2002 to March 2008 in our hospital were analysed retrospectively.Results：The total conversion rate was 1.17%（31/ 2657）,among them 22 cases were referred during operation,while the other 9 after operation.The main cause was operative complication in lg cases accounting for 45.16% ,following by pelvic adhesion in 12 cases for 38.7% ,unusual location of lesion in 3 cases for 8.67% and pelvic malignant tumor in 2 cases for 6.45%.Conclusion：The main causes of conversion operation were operative complication, pelvic adhesion, unusual location of lesion and malignant tumor in turn.It was advantageous to decrease or avoid the occurrence of complications by suitably changing from vaginal surgery to laparotomy during or after operation.