腹腔镜下子宫阔韧带肌瘤剔除术24例临床分析

Clinical analysis of 24 cases of laparoscopic enucleation for myoma in broad ligament of uterus

目的探讨腹腔镜下子宫阔韧带肌瘤剔除的可行性和术中注意事项。方法对24例行腹腔镜下子宫阔韧带肌瘤剔除术患者的临床资料进行回顾性分析。结果 24例患者均在腹腔镜下完成阔韧带肌瘤剔除术,1例中转开腹止血,无一例输尿管损伤。手术时间(142.5±61.6)minutes;术中出血(245.3±312.0)ml,4例失血量≥500 ml,其中1例1 300ml。24例患者均在术后5～7 d治愈出院。结论腹腔镜下子宫阔韧带肌瘤剔除术是一种安全、可行、有效的微创手术方式,其手术的关键在于辨清瘤体与输尿管、子宫动脉之间的解剖关系。

Objective To explore the feasibility of laparoscopic enucleation for myoma in broad ligament of uterus.Methods Twenty-four cases having received laparoscopic enucleation for myoma in broad ligament of uterus were collected and analyzed.Results All were completed with laparoscope,but one patient was converted to open surgery to stop bleeding because of uterine artery injury.No ureteral injury occurred.The average operative time was（142.5±61.6）minutes and the average blood loss volume was（245.3±312.0）ml.The blood loss volume was more than 500 ml in four cases and was 1 300 ml in one.The postoperative hospital stay was five to seven days.Conclusion Laparoscopic nucleation for broad ligament of uterus is safe,effective and minimally invasive.The key point during the operation is to distinguish the anatomical relations among the myoma,ureter and uterine artery.