腹腔镜及开腹手术剔除卵巢子宫内膜异位囊肿疗效的比较研究

目的 :比较腹腔镜手术及剖腹手术治疗卵巢子宫内膜异位囊肿的效果。方法 :回顾分析行腹腔镜及开腹手术剔除子宫内膜异位囊肿 332例患者的临床资料 ,包括症状改善情况 ,术后妊娠率及复发率。结果 :腹腔镜组 1 75例 ,平均手术时间 6 2 0 1± 2 0 0 2min ,术后平均住院 3 38± 1 1 6d ;开腹组 1 5 7例 ,平均手术时间 94 73± 2 1 1 0min ;术后平均住院 6 88± 1 30d ,两组差异有高度显著性 (P <0 .0 0 1 )。术后痛经改善率腹腔镜组为 74 8% ,开腹组为 83 1 % ;术后复发率腹腔镜组为 2 8 77% ,开腹组为 34 1 7% ;不孕症患者术后妊娠率腹腔镜组为 5 0 % ,开腹组为 5 4 4 3% ,两组差异无显著性 (P >0 .0 5 ) ,表明两种手术方法治疗子宫内膜异位囊肿的效果相同。结论 :腹腔镜手术剔除卵巢子宫内膜异位囊肿具有与开腹手术相同的疗效 ,且具有微创的特点 ,应作为首选治疗方法

Comparative study on the efficacy of cystectomy for ovarian endometrioma by laparoscopy and laparotomy

Objective:To compare with the efficacy of ovarian cystectomy for endometrioma by laparoscopy and laparotomy.Methods:A retrospective comparative study was made on the data of 332 patients who had endometrioma and removed by laparoscopy or laparotomy. The efficacy analysis includes improvement of the symptoms, pregnancy rate and recurrence rate after operation.Results:The mean surgical time was 62.01±20.02 minutes and the mean hospitalization after operation was 3.38±1.16 days in laparoscopy group. The mean surgical time was 94.73±21.10 minutes and the mean hospitalization after operation was 6.88±1.30 dyas in laparotomy group. There was a statistical significance between the two groups (P<0.001).74.8% of the patients with dysmenorrhea improved in laparoscopy group and 83.1% in laparotomy group. The recurrence rate was 28.77% in laparoscopy group and 34.17% in laparotomy group. The pregnancy rate was 50% in laparoscopy group and 54.43% in laparotomy group after operation. There was no statistical significance in symptoms improvement, recurrence rate and pregnancy rate after operation between the two groups( P>0.05 ). Conclusions:Laparoscopic surgery has the same efficacy as laparotomy in the treatment of ovarian endometrioma. It is suggested that laparoscopic surgery should be the first choice of treatment for ovarian endometrioma because of its minimally invasive characteristics.