腹腔镜下大子宫(肌瘤)组织取出技术的研究进展

Research Progress of Laparoscopic Uterine(Leiomyoma)Tissue Extraction Technology

妇科手术中子宫及子宫肌瘤标本组织的分碎及取出技术已发展了数十年,包括电动分碎技术、经阴道分碎技术及经腹小切口分碎技术等。近年来,随着腹腔镜等微创手术的广泛开展,妇科手术医生对无瘤观念、无瘤技术愈发重视,对标本的分碎及取出技术提出了更高的要求。不同的技术各有其优点和局限性,各种技术的围手术期并发症发生率无明显差异,但存在经阴道分碎技术标本袋破碎率更高,经腹小切口分碎技术手术时间偏长等的局限性。各种技术的实用性及安全性仍需高质量的前瞻性临床研究来验证。在选择分碎及取出标本方式时,术者应严格遵循治疗原则,进行个体化决策,让患者获得更好的预后。综述大子宫(肌瘤)的分碎及取出技术的相关研究进展,以供临床参考。

The techniques of uterine and uterine leiomyoma specimen tissue morcellation and extraction in gynecological surgery have been developed for decades,including electromechanical morcellation,transvaginal morcellation and small abdominal incision morcellation.In recent years,with the wide spread development of minimally invasive surgery such as laparoscopy,gynecologic surgeons have paid more and more attention to the tumor-free concept and tumor-free technology,and put forward higher requirements for the specimen morcellation and extraction technology.Different techniques have their own advantages and limitations,and there is no significant difference in the incidence of perioperative complications among them,but there are some limitations,such as the higher crushing rate of specimen bags by vaginal morcellation technique and the longer operation time by minilaparotomy morcellation technique.The practicability and safety of various technologies still need high-quality prospective clinical research to verify.When choosing the method of breaking and taking out specimens removal,the operator should strictly follow the principles of treatment and make individualized decisions so that patients can get a better prognosis.This paper reviews the research progress of large uterine(leiomyoma)tissue morcellation and extraction technology for clinical reference.