子宫良性疾病行腹腔镜下子宫体三角形切除术的可行性及价值

目的探讨腹腔镜下行子宫体三角形切除术治疗子宫良性疾病的可行性及价值.方法采用腹腔镜下行子宫体三角形切除治疗子宫良性疾病共18例,其中子宫肌瘤11例和子宫腺肌病6例,功能失调性子宫出血药物治疗无效1例.所有病人手术前均排除子宫恶性疾病.结果所有17例患者手术均在腹腔镜下完成,平均手术时间为176(130～220) min,平均失血量为160.3(110～220) ml,手术后平均住院时间4.3(3～6) d.随诊1～6个月,18例病人症状均完全缓解,B超提示子宫形态较正常子宫略小.无1例手术并发症,3例手术后出现发热.结论采用腹腔镜下子宫体三角形切除术治疗子宫肌瘤或腺肌病临床效果满意,且保留了子宫形态,维持了盆骶的完整性.

Study of laparoscopic triangle hysterectomy for benign uterine diseases

Objective To investigate the possibility and value of laparoscopic triangle hysterectomy. Methods Eighteen patients with benign uterine diseases, including 11 cases of uterine fibroids, 6 cases of adenomyoma, and 1 case of uterine hemorrhage due to functional disorder, underwent laparoscopic triangle hysterectomy. The possibility of uterine cancer was excluded preoperatively. Results Laparoscopic procedures were completed successfully in all 18 patients. The average operating time was 176 min (130-220 min) and the average blood loss was 160.3 ml (110-220 ml). The mean postoperative hospital stay was 4.3 d (3-6 d). The mean follow-up time was 5.2 months (2-12 months). Symptomatic improvement was achieved in all patients. There was no recurrence of fibroids. The main postoperative complications were pyrexia which happened in 2 patients. Sonographic evaluation of the uterine size showed that the reconstructive uteruses were smaller than the normal ones. Conclusion Laparoscopic triangle hysterectomy is effective and safe for treatment of uterine fibroids and adenomyomas and is also helpful for reserving uterine form and structure and maintaining integrity of the pelvic.