腹腔镜下子宫肌瘤剔除术后内翻缝合与“8”字缝合的对比研究

Comparative study of inverting suture and 8-character-pattern suture after laparoscopic myomectomy

目的观察分析腹腔镜下子宫肌瘤剔除术后内翻缝合与"8"字缝合对手术及术后并发症的影响。方法回顾性分析142例腹腔镜下行子宫肌瘤剔除术治疗患者的临床资料,根据缝合方法不同分为内翻缝合组85例采用直褥式内翻缝合,"8"字缝合组57例采用"8"字缝合,观察比较2组患者的手术时间、术中出血、术后并发症差异。结果内翻缝合组手术时间及术中出血均少于"8"字缝合组,单个瘤体子宫后壁部位者手术时间及术中出血多于子宫前壁及子宫底部患者,"8"字缝合组术后1例手术相关盆腔感染,2例盆腹腔黏膜粘连,并发症发生率有统计学差异(P<0.05)。结论腹腔镜下子宫肌瘤剔除术采用直褥式内翻缝合能够缩短手术时间,起到术中止血效果,减少术后盆腔感染及盆腹腔黏膜粘连等并发症的发生。

Objective To observe the effect analysis of inverting suture and 8-character-pattern suture after laparoscopic myomectomy for the operation and postoperative complications. Methods The data of of 142 patients with laparoscopic myomectomy were analyzed retrospectively. According to the different suture methods,they were divided into inverting suture group（ 85 cases） with straight mattress inverting suture and 8-character-pattern suture group（ 57 cases）. The operation time,intraoperative bleeding,postoperative complications between two groups were compared. Results The operation time and intraoperative bleeding of varus suture group were less than those of 8-character-pattern suture group,single tumor posterior uterine wall parts of operation time and intraoperative bleeding than patients with the anterior wall of the uterus and uterine bottom,1 cases of pelvic related operation infection after operation in eight suture group,abdominal and pelvic mucosa adhesion in 2 cases,the complication rates between two groups were statistically difference（ P〈0. 05）. Conclusion Laparoscopic myomectomy with direct mattress inverting suture can shorten operation time,play a good hemostasis in the operation and reduce the incidence of pelvic infection and abdominal and pelvic mucosa adhesion.