腹腔镜下子宫肌瘤剔除术196例临床分析

目的探讨腹腔镜下子宫肌瘤剔除术的影响因素和手术技巧。方法对2003年1月至2004年12月196例腹腔镜子宫肌瘤剔除术病例进行回顾性分析。结果单发肌瘤122例,多发74例;浆膜下肌瘤113例,肌壁间肌瘤62例,浆膜下与肌壁间肌瘤同时存在21例;肌瘤数最多12个,肌瘤平均直径4.51 cm;手术时间平均75.5 min,术中出血平均25.6 ml。子宫肌瘤直径≥6 cm者手术时间和术中出血量明显大于直径<6 cm者,肌瘤数目和肌瘤类型对手术时间和出血量无明显影响。结论子宫肌瘤大小是影响手术时间、术中出血的关键因素。严格掌握手术指征和具备熟练的镜下手术技能是体现腹腔镜手术优越性的关键和保证。

Clinical analysis on relative factors of 196 cases of laparoscopic myomectomy

Objective To explore the factors influencing laparoscopic myomectomy and operative skill.Methods From January 2003 to December 2004,196 patients with uterine myoma underwent laparoscopic myomectomy were respectivly analyzed.Results There were 122 patients suffering with single myoma and 74with multiple myomas,including 113 subserosal myomas,62 intramural and 21 both intramural and subserosal.The maximum number of myoma was 12 and the mean diameter of myomas was 4.51 cm.The mean duration of operation was 75.5minutes and mean blood loss was 25.6ml.The operation lasted longer and the blood loss was more when the myoma was larger than 6 cm(P<0.01).Conclusion The size of the myoma is the most important factor that influenced the operation duration and the blood loss.Patient selection and laparoscopic suturing skill are the key factors in achieving a successful operation.