腹腔镜子宫肌瘤切除术术中先缝合子宫肌壁的应用价值

目的:探讨腹腔镜子宫肌瘤切除术的手术技巧及临床疗效。方法:回顾分析41例患者(观察组)腹腔镜子宫肌瘤切除术术中先缝合子宫肌壁的临床资料,并与常规腹腔镜子宫肌瘤切除术40例对照。结果:81例均顺利完成手术,无中转开腹及手术并发症发生。平均手术时间观察组(73.5±25.7)min,对照组(99.3±26.9)min(P<0.05);术中平均出血量观察组(40.7±21.3)ml,对照组(93.5±34.2)ml(P<0.05)。术后2组病率、肛门排气时间差异无统计学意义(P>0.05)。术后随访6～20个月,平均13个月,影像学检查示局部无肿瘤组织残留或肌瘤复发,无远期并发症发生。结论:先缝合子宫肌壁在腹腔镜子宫肌瘤切除术中具有手术时间短、术中出血少、易于掌握等优点,适于临床应用。

The application value of earlier suture of myometrium in laparoscopic myomectomy

Objective:To investigate the surgical techniques and clinical efficacy of laparoscopic myomectomy.Methods:The clinical data of 41 cases(observation group)underwent laparoscopic myomectomy(myometrium was sutured earlier)and 40 cases(control group)underwent normal laparoscopic myomectomy was retrospectively analyzed.Results:All the operations were successful,without conversion to laparotomy or surgical complications.Mean operating time of observation group was(73.5±25.7)min,and the control group was(99.3±26.9)min(P<0.05).Mean blood loss in observation group was(40.7±21.3)ml,and(93.5±34.2)ml in control group(P<0.05).For the rate of disease and anal exhaust time,there was no significant difference between the 2 groups(P>0.05).Postoperative follow-up was 6-20 months(mean 13 months),there were no local residual tumor,recurrence or long-term complications.Conclusions:Earlier suture of myometrium in laparoscopic myomectomy is suitable for clinical application with advantage of short operative time,less blood loss,and easy to master.