腹腔镜辅助下腹壁小切口子宫肌瘤剔除术的临床应用研究

目的探讨腹腔镜辅助下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2007年7月~2008年7月30例行LAM,与同期130例腹腔镜子宫肌瘤剔除术(laparoscopic myomectomy,LM)进行对比分析。结果LAM组术中出血量(73±28)ml与LM组(81±27)ml无统计学差异(t=1.453,P=0.148),2组手术时间(t=-0.741,P=0.460)、术后病率(χ2=0.000,P=1.000)、术后肛门排气时间(t=0.000,P=1.000)、中转开腹率(0vs12.3%,P=1.000)、并发症发生率(LM组2例,LAM组0例,P=1.000)、术后复发率(LM组8例,LAM组1例,χ2=0.027,P=0.869)差异均无统计学意义。结论LAM治疗子宫肌瘤与LM疗效相当,但LAM可以较LM剔除体积更大、数目更多、生长部位更复杂的子宫肌瘤。

Laparoscopic-assisted Myomectomy with Mini-incision at the Lower Abdomen for the Treatment of Hysteromyoma

Objective To investigate the feasibility and efficacy of laparoscopic-assisted myomectomy（LAM）for the treatment of myoma.Methods From July 2007 to July 2008,totally 30 patients received LAM in hour hospital.At the meantime,130 patients who underwent laparoscopic myomectomy（LM）were set as a control.The clinical data of LAM and LM groups were compared.ResultsNo significant difference was found between the LAM and LM groups in intraoperative blood loss （73±28）ml vs.（81±27）ml,t=1.453,P=0.148],operation time（t=-0.741,P=0.460）,postoperative morbidity（χ^2=0.000,P=1.000）,anal exhaust time（t=0.000,P=1.000）,the rate of conversion to laparotomy（0 vs 12.3%,P=1.000）,rate of complications（2 cases in the LM group vs.0 case in the LAM group,P=1.000）,and the recurrence rate（8 cases in the LM group vs.1 case in the LAM group,χ^2=0.027,P=0.869）.Conclusions LAM shows similar efficacy with LM,but better safety for patients with larger or greater numbers of myoma than LM.