原位肌瘤粉碎法在腹腔镜大子宫肌瘤剔除术中的应用

Application of simultaneous morcellation in situ in laparoscopic myomectomy

目的 探讨原位肌瘤粉碎法在腹腔镜大子宫肌瘤剔除术中的应用价值.方法 将行腹腔镜大子宫肌瘤剔除术患者189例按随机数字表法分为原位粉碎组（94例）和常规剔除组（95例）,并对两组患者手术时间、术中出血量、术后排气时间和术后住院时间等进行比较分析.结果 两组患者均顺利完成手术,无中转开腹.原位粉碎组手术时间明显短于常规剔除组[（98.20±40.70）min比（129.20±68.50）min,P＜0.05],术中出血量少于常规剔除组[（113.40±38.30）ml比（168.90±61.70）ml,P＜0.01];两组术后排气时间和术后住院时间比较,差异均无统计学意义（P＞0.05）.两组各发生皮下血肿1例,无其他术中及术后并发症发生.结论 在腹腔镜大子宫肌瘤剔除术中采用原位肌瘤粉碎法是安全可行的,值得推广.

Objective To discuss the clinical value of simultaneous morcellation in situ in laparoscopic myomectomy （LM）. Methods One hundred and eighty-nine women who underwent LM for symptomatic myomas were randomly divided into in situ group（94 cases） and standard group（95 cases）. The operation time, hemorrhage perioperative,exhaust time postoperative, length of hospital stay were compared.Results The operation was successful in two groups. The operation time and hemorrhage perioperative in situ group were significantly less than those in standard group [ （98.20 ± 40.70） min vs. （ 129.20 ± 68.50）min （P〈0.05） and （113.40± 38.30） ml vs. （168.90±61.70） ml （P〈0.01）]. There was no statistical difference in exhaust time postoperative, length of hospital stay between two groups （P 〉0.05）. One case occurred eechymoma in two groups respectively. Conclusion The application of simultaneous morcellation in situ in LM is safe and feasible.