经腹子宫肌瘤切除术和腹腔镜子宫肌瘤切除术术后复发率的比较

目的:探讨经腹子宫肌瘤切除术（OM）和腹腔镜子宫肌瘤切除术（LM）术后复发率的区别。方法:收集我院2008年1月至2018年1月期间住院治疗且有完整临床病理数据的子宫肌瘤患者，共纳入接受LM治疗的276例和接受OM治疗的193例。术后随访6个月至8年不等，比较LM组和OM组患者临床病理学特征区别，统计两组患者术后累积复发率，并进行Cox比例风险模型分析影响术后复发的因素。结果:LM组和OM组患者的术后累积复发率分别为第1年11.9％和6.3％，第3年40.8％和31.8％，第5年59.7％和42.9％，第8年74.2％和63.9％，对数秩检验显示两组复发率存在统计学差异。Cox回归分析显示，LM和术后无妊娠显著增加了术后复发风险。结论:LM和术后无妊娠的子宫肌瘤患者术后复发率更高，但仍需要大规模前瞻性随机对照研究来进一步证实。

Comparative study of recurrence rate after open myomectomy and laparoscopic myomectomy

Objective:To investigate the difference of recurrence rates after open myomectomy (OM) and laparoscopic myomectomy (LM).Methods:A total of 276 patients receiving LM and 193 receiving OM between January 2008 and January 2018 were included.The patients were followed up postoperatively from 6 months to 8 years.The clinical pathological features of LM group and OM group were compared,and the cumulative recurrence rates after LM and OM were calculated.The Cox proportional hazard model was used to analyze the factors affecting postoperative recurrence.Results:The cumulative recurrence rates after surgery of LM group and OM group were 11.9% and 6.3%,40.8% and 31.8%,59.7% and 42.9%,and 74.2% and 63.9% at 1,3,5,8 years after the operation.There were significant differences in recurrence rates between the two groups.Cox regression analysis showed that LM and the absence of postoperative pregnancy significantly increased the risk of postoperative recurrence.Conclusion:Patients with LM and the absence of postoperative pregnancy have higher recurrence rate,but large-scale prospective randomized controlled trials are needed to confirm this.