腹腔镜宫颈肌瘤切除术的临床分析

目的:探讨腹腔镜宫颈肌瘤切除术的手术效果、适应证及技巧。方法:回顾分析腹腔镜宫颈肌瘤切除术36例患者的临床资料。结果:36例患者均在腹腔镜下顺利完成宫颈肌瘤切除术。肌瘤直径3~10 cm,平均5.7 cm。平均手术时间(86.8±46.75)m in,术中平均出血(66.6±35.5)m l。直径≥5 cm的肌瘤比<5 cm者平均手术时间及术中出血均明显增加(P<0.01)。术后随访症状均有改善。结论:腹腔镜宫颈肌瘤切除术安全可行,合理选择适应证及高超的手术技巧是手术成功的关键。     

经阴道与腹腔镜下子宫肌瘤剔除术临床对比分析

目的探讨经阴道子宫肌瘤剔除术与腹腔镜下子宫肌瘤剔除术的临床效果。方法回顾分析经阴道子宫肌瘤剔除术85例和同期行腹腔镜下子宫肌瘤剔除术96例的术中、术后及随访情况。结果两组术后胃肠功能恢复时间无统计学差异，经阴道组手术时间、术中出血量及医疗费用均少于腹腔镜组（P〈0．05），但术后病率高于腹腔镜组（P〈0．05）。结论经阴道及腹腔镜下子宫肌瘤剔除术两种微创术式各有优势。     

Multidisciplinary Approach in Large-sized Submucosal Myoma: Hysteroscopic Myomectomy after Uterine Artery Embolization

Study Objective

To evaluate the safety and effectiveness of hysteroscopic myomectomy after uterine artery embolization (UAE) for the treatment of large-sized submucosal myomas with deep intramural invasion that are difficult to treat with 1-step hysteroscopy.

A new nonabsorbable adhesion barrier for myomectomy

BACKGROUND: A pilot study was made to assess the efficacy and safety of a new nonabsorbable adhesion barrier (Shelhigh Dome Pericondial Patch No-React Treated) in reducing adhesion after extensive myomectomy by laparotomy with a planned second-look laparoscopy. METHODS: In 20 patients after extensive myomectomy and full thickness uterine wall reconstruction, the patch was sutured over the uterus. Second-look laparoscopy was performed 6 weeks postoperatively. Third-look laparoscopy was done in 3 patients. RESULTS: Surgeries were completed without intraoperative or postoperative complications. No problems related to the patch were encountered including the need for its removal. At laparoscopy no adhesions between the abdominal wall, bladder, small bowel, or sigmoid colon to the uterus were noticed. A thin layer of the omental edge covered the patch that was securely anchored to the uterine fundus. The mean follow-up was 13 months. CONCLUSIONS: These findings suggest benefits with this new bovine/porcine pericardial adhesion barrier for myomectomy. Controlled clinical trials are warranted.     

腹腔镜与剖腹子宫肌瘤剔除术对照研究

目的探讨腹腔镜下子宫肌瘤剔除术的临床应用价值。方法对腹腔镜子官肌瘤剔除术(n=64)与剖腹子宫肌瘤剔除术(n=46)两组患者临床特征、手术时间、术中出血量、术后体温正常例数、肠功能恢复时间和住院日进行对比分析。结果两组患者年龄、肌瘤类型、子宫大小、肌瘤大小差异无显著意义(P＞0．05)，手术时间、术中出血量、术后体温正常例数、肠功能恢复时间和住院日差异有显著意义(P＜0．05)。结论腹腔镜下子宫肌瘤剔除术与剖腹子官肌瘤剔除术相比，具有创伤小、手术时间短、术中出血少、术后肠功能恢复快、住院目短和并发症少等优点，可替代剖腹子宫肌瘤剔除术。     

腹腔镜与开腹子宫肌瘤剔除术的临床效果观察

目的　探讨腹腔镜下子宫肌瘤剔除术的应用价值。方法　比较腹腔镜子宫肌瘤剔除术 78例(观察组 )和开腹子宫肌瘤剔除术 6 7例 (对照组 )病人的手术和术后情况。结果　观察组手术时间 81 0 9±2 3 81min ,术中出血 32 15± 2 5 0 2ml,术后平均 1 2 8± 0 80d体温恢复正常 ,术后住院 4 12± 1 0 0d。对照组手术时间 83 6 5± 30 5 0min ,术中出血 86 5 8± 6 5 30ml,平均 2 82± 1 35d体温恢复正常 ,术后住院 7 6 4± 1 6 7d。结论　腹腔镜下子宫肌瘤剔除术具有创伤小、术中出血少、术后恢复快及住院时间短等优点。     

妊娠早期巨大子宫肌瘤术后分娩1例并文献复习

目的 探讨妊娠早期子宫肌瘤切除术的可行性及妊娠期肌瘤术后分娩方式和时机的选择。方法 回顾性分析山东第一医科大学附属省立医院妊娠早期巨大子宫肌瘤切除术后足月经阴分娩1例患者的临床资料,并进行文献复习。结果 患者于妊娠32 d行全麻下子宫肌瘤切除术,孕期正规产检,过程顺利,于孕41周人工破膜后经阴分娩一活婴,产后恢复好,顺利出院。结论 妊娠期早期子宫肌瘤切除手术是可以尝试的,可于妊娠36～38⁺⁶周择期剖宫产。肌瘤切除过程中子宫肌层完整性未受到显著破坏者,可严密监护下阴道试产,分娩孕周可延长至41周。子宫肌瘤切除术后的催引产需谨慎,不建议40周以后的引产。     

腹腔镜下子宫肌瘤切除术178例分析

目的：分析腹腔镜子宫肌瘤切除术的手术效果。探讨该手术的适应征,手术技巧及并发症。方法：选择178例子宫肌瘤患者进行腹腔镜手术,依肌瘤的类,大小以不同的方法行肌瘤切除术,结果：共切除肌瘤277个,肌瘤直径1－12cm,平均肌瘤直径5．1cm,平均手术时间及术中出血量分别为101min及83ml,肌瘤＞8cm者比肌瘤＜5cm者手术时间明显延长（P＜0．05）,肌瘤＞8cm者比肌瘤≤8cm者出血量明显增加（P＜0．01）,术后平均住院时间为4．7d,并发症率7．3％,结论：中等大的浆膜下肌瘤或肌壁间肌瘤行腹腔镜肌瘤切除术效果好,并发症发生率低,术后住院时间短,并能保留子宫,维持正常月经和生育功能。     

Management of a massive leiomyoma in pregnancy

This is a case report of a primigravida who was noticed to have a large pelvic mass at the time of her “booking” scan. A magnetic resonance imaging (MRI) scan was performed in order to elucidate the exact nature of the mass, which enlarged between successive scans. The appearances were in keeping with a leiomyoma undergoing degenerative change. The patient underwent a laparotomy in pregnancy to remove the leiomyoma, which was found to contain fluid-filled cavities. The uterine cavity was not breached at the time of surgery. The pregnancy continued uneventfully until term, and the baby was delivered by caesarean section. The postnatal period was uneventful.     

腹腔镜子宫肌瘤剔除术57例临床分析

目的 探讨腹腔镜子宫肌瘤剔除术的临床使用价值。方法 对57例子宫肌瘤患者进行充分的术尊登焦后行腹贮镜下子宫肌瘤剔除术。结果 全组57例手术全都成功，其中浆膜下肌瘤32例、肌壁间肌瘤25例，肌瘤粤径．3-10cm.手术时间41-129min，平均97．6min，出血量30．200ml，平均100ml；术后体温最高38．1℃，2d后恢复正常，术后住院4．6d。结论　腹腔镜子宫肌瘤剔除术是目前一种安全、有效、微创的手术方法。