腹腔镜下子宫肌瘤切除术178例分析

ANALYSIS OF LAPAROSCOPIC HYSTERO-MYOMECTOMY IN 178 CASES

目的 :分析腹腔镜子宫肌瘤切除术的手术效果 ,探讨该手术的适应征 ,手术技巧及并发症。方法 :选择178例子宫肌瘤患者进行腹腔镜手术 ,依肌瘤的类型、大小以不同的方法行肌瘤切除术。结果 :共切除肌瘤2 77个 ,肌瘤直径 1～ 12cm ,平均肌瘤直径 5 .1cm。平均手术时间及术中出血量分别为 10 1min及 83ml,肌瘤>8cm者比肌瘤 <5cm者手术时间明显延长 (P <0 .0 5 ) ,肌瘤 >8cm者比肌瘤≤ 8cm者出血量明显增加 (P <0 .0 1) ,术后平均住院时间为 4.7d ,并发症率 7.3%。结论 :中等大的浆膜下肌瘤或肌壁间肌瘤行腹腔镜肌瘤切除术效果好 ,并发症发生率低 ,术后住院时间短 ,并能保留子宫 。

Objective:To analyse the indication,surgical technique and complications of laparoscopic myomectomy. Method:A retrospective study was carried out of 178 patients with uterine myoma(UM).Correlative myomectomy were preformed based on the different types and size of UMs. Results:A total of 277 UMs were removed from these patients.The size of dominant UMs ranged from 1～12cm(mean 5.1cm).Mean duration of operation was 101 minutes and mean blood loss was 83ml.Longer operation time was observed in patients with UMs>8cm than those with UMs<5cm( P <0.05).More blood loss was observed in patients with UMs>8cm than those with UMs≤8cm( P <0.01).Mean postoperative hospital stay was 4.7 days and overall complication rate was 7.3%.Conclusions:This study suggests the feasibility of laparoscopic myomectomy in selected patients,leading to effectiveness,low complication rate and short hospital stay.Uterus can be reserved,normal menstruation can be maintained and fertility can be preserved.