腹腔镜子宫肌瘤挖除术的手术技巧探讨

目的：探讨腹腔镜子宫肌瘤挖除术的各种手术技巧。方法：回顾性分析80例行腹腔镜子宫肌瘤挖除术患者的手术资料。结果：80例中12例既往有腹部开放性手术史,均成功在腔镜下完成手术;80例患者随机分为对照组和治疗组,治疗组40例均加用双极电凝子宫动脉的方法,对照组40例采用传统术式。有腹部开放性手术史与无腹部开放性手术史患者在手术时间、术中出血量、中转开腹率及住院时间上差异均无显著性（P〈0.05）,对照组和治疗组术中出血、术后肌瘤复发率差异均有显著性（P〈0.05）。结论：有腹部开放性手术史并非是妇科腹腔镜手术的禁忌证,合理选择患者,熟练掌握腹腔镜操作技巧是顺利完成该类手术的关键,同时腹腔镜下子宫肌瘤挖除加双极电凝子宫动脉可以达到在治疗子宫肌瘤的同时减少手术中出血和预防肌瘤复发及减缓肌瘤生长的目的。

Discussion of surgical technique of laparoscopy-assisted hysteromyomectomy

Objective：To probe into the various surgical techniques of laparoscopy-assisted hysteromyomectomy.Methods：To analysize the surgical materials of 80 patients who received laparoscopy-assisted hyteromyomectomy retrospectively.Results：Of 80 cases, 12 cases had open abdominal operation history and succeed in finishing the operation with the help of celioscope;80 patients were divided into a control group and treatment group at random.40 patients in treatment group adopted the bipolar coagulation of arteriae uterina ,40 in control group adopted the traditional operation. There is no significant difference （P〉0.05） between the patients with and without open abdominal operation history in the time of surgery,blood loss volume in surgery, the rate of transfer into open abdominal operation and the time of hospitalization, while there was significant difference （P〈0.05） in blood loss, postoperative recurrence rate of myoma.Conclusion： The history of an open abdominal surgery is not the surgery contraindication of celioscope, the key of finishing these kind of surgery successfully is to choose patients reasonably, master the techniques of laparoscopic operation proficiently.Meanwhile with the help of laparoscope,hystaromyomectomy and bipolar coagulation of arteriae uterina can treat hysteromyoma,at the same time it can reduce the bleeding,prevent myoma recurrence and slow the growth of myoma.