腹腔镜结合腹壁小切口行子宫肌瘤剔除术的临床应用

目的探讨腹腔镜结合腹壁小切口子宫肌瘤剔除术(laparoscopically assisted myomectomy,LAM)治疗子宫肌瘤的临床意义。方法选取2010~2013年金堂纺织医院收治的子宫肌瘤患者160例,LAM组80例,行腹腔镜结合腹壁小切口子宫肌瘤剔除术,采用腹腔镜子宫肌瘤剔除术(laparoscopic myomectomy,LM)80例。观察比较两组的手术时间、术中出血量、并发症及术后恢复情况。结果平均手术时间LAM组(82.73±15.27)min少于LM组(133.43±17.56)min(P0.05),术中平均出血量LAM组(95.10±30.16)mL少于LM组(137.37±28.95)mL(P0.05);两组术后3 d平均体温、术后肛门排气时间、术中严重并发症的发生率及术后住院天数比较,差异无统计学意义(P0.05)。结论 LAM与LM均是成熟的子宫肌瘤剔除术式,但LAM可简化缝合操作,对瘤体较大缝合较多的子宫肌瘤剔除较为有利;术中触摸可最大限度发现肌瘤,降低肌瘤复发率,更适合腹腔镜在基层医院推广。

Clinical application of laparoscopically assisted myomectomy with abdominal mini-incision in the treatment of hysteromyoma

Objective To investigate the efficacy of laparoscopically assisted myomectomy（ LAM ） with abdominal mini-incision in the treatment of hysteromyoma. Methods 160 patients with hysteromyoma in Jintang Textile Hospital from 2010 to 2013 were randomized into LAM group and laparoscopic myomectomy（ LM）group with 80 cases in each group. Patients in LAM group underwent LAM with abdominal mini-incision,while patients in LM group underwent laparoscopic myomectomy. The operation time,blood loss during operation,complications and postoperative recovery of the two groups were compared. Results The average operation time in LAM group（82. 73 ±15. 27）min was less than LM group（133. 43 ± 17. 56）min（P〈0. 05）. The bleeding loss during operation in LAM group（95. 10 ± 30. 16）mL was less than LM group（137. 37 ± 28. 95）mL（P 〈0. 05）. No statistical differences were found in average temperature three days after operation,anus exhaust time,severe complications and postoperative hospital stay between two groups（ P〉0. 05 ）. Conclusions Both LAM and LM operation are mature myomectomy operations,LAM can simplify the operation of suture,especially for the large tumors. The intra -operative touch is helpful for detection of hysteromyoma and decrease the rate of recurrence,which is suitable for utilization of laparoscopy in primary hospital.