改良腹腔镜子宫腺肌病巨大子宫切除术14例报道

Modified Laparoscopic Hysterectomy for Large Uterus in Woman with Adenomyosis:a Report of 14 Cases

目的探讨腹腔镜子宫切除术治疗大于12孕周子宫腺肌病的手术技巧和安全性。方法2012年12月～2013年12月，对14例12～18孕周的子宫腺肌病行腹腔镜子宫切除术，对子宫血管的处理和子宫离断方式等步骤进行改良。结果14例均在腹腔镜下完成子宫切除术，无中转开腹，无并发症发生。手术时间（160．7±66．1）ｍin，术中出血量（184．3±50．5）ml。结论改良手术步骤后行腹腔镜子宫腺肌病巨大子宫切除术是安全的。

Objective To investigate surgical skills and safety of laparoscopic hysterectomy procedure tot enlarged uterus in woman with adenmyosis. Methods Fourteen cases of adenomyosis with uterus larger than twelve-week pregnancy accepted laparoscopic hysterectomy form December 2012 to December 2013 in our hospital. Some operating techniques, including the management of uterine vessels and separation of cardinal ligament and uterosacral ligament, were modified. Results The operation was performed successfully under laparoscopy in all the cases. No conversion to open surgery was required. No operating complication happened. The operating time was （ 160.7 ± 66.1 ） min, and the intraoperative blood loss was （ 184.3 ± 50.5） ml. Conclusion Modified laparoscopic techniques should be considered as an acceptable alternative in hysterectomy for the management of large uterus in woman with adenomyosis.