腹腔镜与开腹子宫肌瘤剔除术后肌瘤残留与复发及妊娠结局的比较

Comparison of residual fibroids,recurrence and pregnancy outcome after laparoscopic and open myomectomy

目的探究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。方法选取2020年1月至2021年1月本院收治的100例子宫肌瘤患者作为研究对象,按照随机数字表法分为研究组与常规组,每组50例。常规组采用开腹子宫肌瘤剔除术,研究组采用腹腔镜子宫肌瘤剔除术,比较两组围术期指标、并发症发生率、肌瘤残留率、复发率及妊娠率。结果研究组手术操作时间、术后离床时间、术后排气时间、住院时间均短于常规组,手术失血量少于常规组,差异有统计学意义(P<0.05)。研究组术后并发症发生率为6.00%,低于常规组的22.00%,差异有统计学意义(P<0.05)。两组术后复发率、肌瘤残留率、妊娠率比较差异均无统计学意义。结论开腹子宫肌瘤剔除术与腹腔镜子宫肌瘤剔除术均能有效减少肌瘤残留,降低复发风险,改善子宫肌瘤患者妊娠结局。但腹腔镜手术操作更简单,具有出血量少、术后并发症少、恢复快等优势,能进一步减轻对患者的创伤,值得临床推广应用。

Objective To explore the residual fibroids,recurrence and pregnancy outcome after laparoscopic and open myomectomy.Methods 100patients with uterine fibroids admitted to our hospital from January 2020 to January 2021 were selected as the research subjects,and they were divided into study group and routine group according to the random number table method,with 50 cases in each group.The routine group used open myomectomy,and the study group used laparoscopic myomectomy.The perioperative indicators,complication rate,fibroids residual rate,recurrence rate and pregnancy rate were compared between the two groups.Results The operation time,postoperative time to get out of bed,postoperative exhaust time,and hospital stay in the study group were shorter than those of the routine group,and the blood loss during operation was less than that of the routine group,the difference was statistically significant(P<0.05).The postoperative complication rate in the study group was 6.00%,which was lower than the 22.00% in the routine group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the postoperative recurrence rate,fibroids residual rate,and pregnancy rate between the two groups.Conclusion Both open myomectomy and laparoscopic myomectomy can effectively reduce the residual fibroids,reduce the risk of recurrence,and improve the pregnancy outcome of patients with uterine fibroids.However,laparoscopic surgery is simpler,has the advantages of less bleeding,less postoperative complications,and faster recovery,it can further reduce the trauma to the patient and is worthy of clinical application.