腹腔镜下子宫大肌瘤剔除术方法改进

A novel modification of conventional laparoscopic myomectomy for large uterine myoma

目的该研究通过对腹腔镜下大子宫肌瘤剔除术方法的改进,探讨其临床效果。方法选择肌瘤直径≥5 cm为研究对象,其中改进腹腔镜下子宫肌瘤剔除术组(改进组)50例与以往腹腔镜子宫肌瘤剔除术组(对照组)58例进行比较,观察术中出血,手术时间,手术并发症等。结果对改进后腹腔镜下肌瘤剔除术组(改进组)与常规腹腔镜下肌瘤剔除组(对照组)进行比较:其中,手术时间:改进组(101.90±30.84)min,对照组(136.90±49.87)min;P<0.001,术中出血:改进组(145.40±92.19)ml,对照组(207.41±158.74)ml;P<0.05,手术并发症:改进组术中无输血,对照组术中输血3例;改进组术后无肠粘连发生,对照组肠粘连2例。结论腹腔镜下较大子宫肌瘤剔除方法安全且可行,改进后手术时间短且出血少,减少了输血事件发生,降低了手术并发症。

【Objective】To evaluate the efficacy and feasibility of a novel modification of conventional laparoscopic myomectomy for large uterine myoma. 【Methods】In this study, the records of 50 women who underwent modified laparoscopic myomectomy and 58 women who underwent conventional laparoscopic myomectomy were reviewed. The uterine myoma diameter of 108 enrolled patients in this study was ≥5.0 cm. Patient data of surgical time, complications and blood loss were compared between the 2 surgical groups. 【Results】the average surgical time in modified and conventional group was（101.90±30.84） min and（136.90±49.87） min, P〈 0.001. The blood loss of modified group was（145.40±92.19） m L, and conventional group was（207.41±158.74） m L, P 〈0.05. No patients in the modified group required a blood transfusion compared with 3 patients in the conventional group. There was no occurrence of intestinal adhesion in the modified group. Two patients in conventional group developed intestinal adhesion. 【Conclusion】The modified laparoscopic myomectomy is a feasible and safe approach in the surgical treatment of large uterine myomas. We can decrease the operation time, reduce the blood loss and complications for patients with larger size of uterine myomas.