腹腔镜下切除子宫后壁肌瘤缝合方法探讨

The discussion of laparoscopic excision of the posterior wall of the uterus myoma suture method

目的:探讨腹腔镜切除子宫后壁肌瘤的缝合方法,并与开腹手术进行比较。方法:选择2008年8月～2009年5月我院33例单发的子宫后壁壁间肌瘤患者,将其随机分为腹腔镜组和开腹组。其中,9例开腹手术,采用常规手术方式;24例在腹腔镜下手术,采用连续水平褥式内翻缝合法,缝合子宫肌层及浆肌层。对两组手术时间及出血量进行分析对比。结果:24例腹腔镜手术均顺利完成此种方式的缝合,平均手术时间(55±18)min(35～90min);术中出血量(62±42)ml(10～110ml)。9例开腹手术时间(60±9)min(45～70min);术中出血量(64±35)ml(20～100ml)。两组手术时间及出血量比较均无显著性差异(P>0.05)。结论:腹腔镜下子宫后壁的肌瘤切除,依靠更快捷的缝合方法,完全可以和非常成熟的开腹手术相媲美,充分体现了腹腔镜手术的优越性。

Objective：To discuss the quick suture technique of laparoscopic hysteromyoectomy in the back intramural myoma and compared with laparotomy.Methods：33 patients with single posterior intramural uterine myoma from August 2008 to May 2009 in our hospital were divided into laparoscopic group and laparotomy group.Among them,laparoscopic hysteromyoectomy were performed in 24 patients successfully and laparotomy in 9 patients.Laparoscopic hysteromyoectomy was used Connell＇s suture.The operation time and bleeding of laparoscopic hysteromyoectomy and laparotomy were compared.Results：The mean operation time was（55±18） min（35-90 min）;bleeding during operation was（62±42） ml（10-110 ml） in the laparoscopic hysteromyoectomy.The mean operation time was（60±9） min（45-70 min）;bleeding during operation was（64±35） ml（20-100 ml） in the laparotomy（P〉0.05）.Conclusion：The quick suture technique of laparoscopic hysteromyoectomy is a less invasive than laparotomy.It can advance quality of laparoscopic hysteromyoectomy.