腹腔镜与开腹子宫肌瘤剔除术后肌瘤残留、复发及妊娠结局的比较

Comparison of myoma residue, recurrence and pregnancy outcomes after laparoscopic and laparotomic myomectomy

目的观察比较腹腔镜与开腹子宫肌瘤剔除术对术后肌瘤残留、复发及妊娠结局的影响。方法选择我院妇产科2012年2月~2014年7月收治的108例有生育要求的子宫肌瘤患者,随机分为腹腔镜组和开腹组,每组54例,开腹组行常规开腹子宫肌瘤剔除术,腹腔镜组行腹腔镜子宫肌瘤剔除术。比较两组手术时间、术中出血量、术后并发症发生率以及住院时间;并对所有患者随访6个月,比较两组肌瘤残留率、肌瘤复发率以及妊娠率。结果与开腹组比较,腹腔镜组手术时间、术中出血量、术后并发症发生率以及住院时间肌瘤均明显降低,差异有统计学意义（P〈0.05）;随访6个月,两组肌瘤残留率、复发率以及妊娠率比较比较,差异无统计学意义（P〉0.05）。结论腹腔镜与开腹子宫肌瘤剔除术均为治疗子宫肌瘤的有效手术方式,腹腔镜子宫肌瘤剔除术对患者的损伤更小,术后并发症发生率较低。

Objective To observe the influences of laparoscopic and laparotomic myomectomy on the postoperative myoma residue, recurrence and pregnancy outcomes. Methods 108 patients with uterine myoma having birth demand treated in the gynecology department of our hospital from February 2012 to July 2014 were randomly divided into the laparoscopy group and the laparotomy group,with 54 patients in each group.The laparotomy group was given conventional laparotomic myomectomy and the laparoscopy group was given laparoscopic myomectomy.The operative time,intraoperative blood loss,incidences of postoperative complications and hospital stay of the two groups were compared.All the patients were followed up for 6 months,and the myoma residue rates,myoma recurrence rates and pregnancy rates of the two groups were compared. Results Compared to the laparotomy group,the laparoscopy group had significantly reduced operative time,intraoperative blood loss,incidence of postoperative complications and hospital stay, with statistically significant differences（P〈0.05）.After 6 months′ follow-up visit,the differences between the two groups in the myoma residue rate,recurrence rate and pregnancy rate were not statistically significant（P〉0.05）. Conclusion Both laparoscopic and laparotomic myomectomy are effective operative methods for the treatment of uterine myoma, and laparoscopic myomectomy causes smaller injury to patients and lower incidence of postoperative complications.