腹腔镜子宫动脉阻断和肌瘤挖除治疗子宫肌瘤的效果

Combined laparoscopic uterine artery blockage and myomectomy: a new approach for treating uterine myoma

目的 评估腹腔镜子宫动脉阻断和肌瘤挖除治疗子宫肌瘤的效果。方法 2 0 0 0年 8月至 2 0 0 1年 8月期间 ,对 42例有症状且要求保留子宫的子宫肌瘤患者采用腹腔镜子宫动脉阻断和肌瘤挖除术治疗。结果 本组病例大部分为多发子宫肌瘤患者 ,其中肌壁间肌瘤 1 9例 ,浆膜下肌瘤 2 3例 ,数目 1～ 6个 ,肌瘤直径大小 2～ 1 2cm ,3 6例 (6 4 3 % )子宫切口进行了缝合。平均手术时间和平均估计失血量分别为 (1 2 4 2± 3 3 1 )min和 (1 1 7 8± 48 6 )ml,病人平均住院日为 (4 8± 1 2 )d。所有病例腹腔镜手术均成功 ,无手术并发症。随访 2～ 1 2月 ,所有有症状者术后均改善 ,无一例复发和手术后并发症。结论 腹腔镜下子宫动脉结扎和肌瘤挖除是一种安全。

Objective To evaluate the effects of combined laparoscopic uterine arteries blockage and myomectomy in the treatment of symptomatic fibroids in the uterus. Methods From August 2000 to August 2001, 42 women with symptomatic fibroids which required surgical treatment and uterus retaining at same time were operated on with combine laparoscopic uterine arteries blockage and myomectomy. The patients were followed for 2 to 12 months. Results There were 19 intramural fibroids and 23 subserous fibroids in those 42 patients and most of them had multi myomata of uterus, ranging from 1 to 6 in number and 2 to 12 cm in size. The uterine wall suturing in one layer was performed in 36 cases (64.3%). The average operating time, blood loss and hospitalization time was (124.2±33.1) min, (117.8±48.6) ml and (4.8±1.2) d respectively. All patients underwent technically successful combined laparoscopic uterine arteries blockage and myomectomy without intra and post operative complications. Symptomatic improvement was achieved in all patients and no recurrence of myoma was seen during the follow up. Conclusion Combined laparoscopic uterine arteries blockage and myomectomy appears to be a safe, effective and promising new method for treating symptomatic uterine leiomyoma.