妇科腹腔镜手术中转开腹的原因分析

目的分析妇科腹腔镜手术中转开腹的原因。方法回顾性分析我院2000年1月-2005年3月1066例妇科腹腔镜手术中53例中转开腹的临床资料。结果因盆腔粘连、肌瘤切除困难、恶性疾病、并发症4种原因中转开腹分别为23、10、9、3例，分别占43．4％（23／53），18．9％（10／53），17．0％（9／53）和5．7％（3／53）。结论盆腔粘连导致腹腔镜下操作困难是中转开腹的第1位原因。选择合适病例，提高术前对良、恶性卵巢肿瘤的判断能力可降低中转开腹率。

Analysis for conversions to open surgery in gynecological laparoscopic operations

Objective To study reasons for conversions to open surgery in gynecological laparoscopic operations.Methods Clinical records of 53 cases of conversions to open surgery out of 1 066 cases of gynecological laparoscopic operations from January 2000 to March 2005 in this hospital were analyzed retrospectively.Results The reasons for conversions included pelvic adhesion in 23 cases,difficulty in myomectomy in 10 cases,malignant tumors in 9 cases,and intraoperative complications in 3 cases,accounting for 43.4%(23/53),18.9%(10/53),17.0%(9/53),and 5.7%(3/53) of the 53 cases,respectively.Conclusions Pelvic adhesion,which leads to difficulties in laparoscopic performance,is the primary reason for conversion to open surgery.Proper patient selection and improved capability for distinguishing benign ovarian tumors from malignant ones can decrease the incidence of conversions.