摘要
目的:探讨腹腔镜辅助腹壁小切口切除子宫腺肌瘤的可行性及安全性。方法:回顾分析2006至2007年要求保留子宫的58例子宫腺肌瘤患者的临床资料,其中18例行腹腔镜辅助腹壁小切口子宫腺肌瘤切除术(组Ⅰ),23例行单纯腹腔镜子宫腺肌瘤切除术(组Ⅱ),17例行开腹子宫腺肌瘤切除术(组Ⅲ),所有患者术后均常规予以GnRH-a治疗3个月,比较分析3组患者手术时间、术中出血量、术后恢复情况、术后并发症、子宫腺肌瘤复发及痛经改善情况。结果:组Ⅰ、组Ⅲ的平均手术时间较组Ⅱ明显缩短(P<0.05);组Ⅰ、组Ⅱ的术中出血量、术后排气时间、术后住院时间较组Ⅲ明显减少(P<0.05);组Ⅰ术后未发生出血、子宫裂开、感染等并发症,组Ⅱ术后1例瘤腔出血子宫裂开,组Ⅲ1例切口脂肪液化延期愈合。复发率及痛经改善情况3组无显著差异。结论:腹腔镜辅助腹壁小切口子宫腺肌瘤切除术既能达到与开腹手术相同的效果,又避免了单纯腹腔镜子宫腺肌瘤切除术缝合子宫操作困难、术中出血多、缝合不严密所致的术后出血、子宫裂开等弊端,同时保留了腹腔镜手术的优点,值得推广应用。
Objective：To investigate the safety and feasibility of the excision of uterine adenomyoma through laparoscopic assisted operation with small abdominal incision.Methods：The clinical data of 58 cases of uterine adenomyoma with reserved uterus in 2006 and 2007 were reviewed retrospectively.Among those cases,18 patients underwent laparoscopic assisted excavations with small abdominal incisions（Group Ⅰ）,23 patients were treated with standard laparoscopic excavations（Group Ⅱ）,and the remained 17 patients had adenomyoma excision through laparotomy（Group Ⅲ）.All 58 patients were routinely administered with GnRH-a for 3 months after their operations.The operation time,blood loss during operation,the postoperative recovery,complications,recurrence rate of adenomyoma,and relief from menstrual cramps were then evaluated and compared.Results：The average duration of surgery in group Ⅰ and Ⅲ was significantly shorter compared to Group Ⅱ（P0.05）;blood loss during operation,postoperative flatus time and hospital stay in Group Ⅰ and Ⅱ were significantly shorter compared to Group Ⅲ（P 0.05）;No postoperative hemorrhage,dehiscence of uterus,or infection was observed in Group Ⅰ,1 patient had postoperative hemorrhage and dehiscence of uterus in Group Ⅱ,1 patient occurred steatosis and delayed union in Group Ⅲ.There were no significant differences among 3 groups on recurrence rate of adenomyoma and the relief of menstrual cramps after operations.Conclusions：Laparoscopic assisted uterine adenomyoma excavation with small abdominal incision,not only attains the effectiveness of abdominal surgery and all advantages of laparoscopic surgery,but avoids the difficulties in suturing,reduces blood loss,and lowers the risk of postoperative hemorrhage and uterine dehiscence in standard laparoscopic surgery,thus,is worthy of clinical application and popularization.
出处
《腹腔镜外科杂志》
2011年第5期330-332,共3页
Journal of Laparoscopic Surgery
