悬吊式无气腹腹腔镜巨大子宫肌瘤切除术的初步观察及文献复习

目的初步探讨悬吊式无气腹腹腔镜巨大子宫肌瘤切除术的可行性、安全性以及术后恢复情况;同时对悬吊式无气腹腹腔镜子宫肌瘤切除术的优劣进行文献复习。方法 2010年11月至2011年3月,3例有子宫肌瘤切除指征,直径≥10cm肌瘤患者,采用悬吊式无气腹腹腔镜及配套设备,行子宫肌瘤切除术,观察手术时间、术中出血量、切除肌瘤重量、排气时间、住院时间及并发症。结果 3例患者手术均成功,无术中、术后并发症发生,手术时间(88±11)min,术中出血量(743±251)ml,子宫肌瘤重量(320±80)g,排气时间(1.5±0.5)d,手术后3d均出院。结论悬吊式无气腹腹腔镜在子宫肌瘤切除术中是安全可靠的,具有手术时间短、缝合可靠的优点,特别适合在巨大肌瘤切除术中使用。但手术出血的问题依然值得关注。

Laparoscopic myomectomy for large symptomatic hysteromyoma by suspended gasless laparoscopy:A preliminary report and review of the literatures

Objective To study the feasibility,safety and postoperative recovery of Laparoscopic myomectomy(LM) for hysteromyomas by suspended gasless laparoscopic myomectomy and at same time to review relative literatures of gasless laparoscopic myomectomy.Methods A series of 3 consecutive patients with 1 symptomatic myoma(diameter≥10 cm) underwent a gasless laparoscopic myomectomy with the subcutaneous abdominal wall-lifting device from November 2010 to March 2011.The data of operating time,intra-operative blood loss,the weight of uterus,the first anal deflation time,hospital stay and the complications were recorded and analyzed.Results Gasless laparoscopic myomectomy was successful in all 3 consecutive patients without intraoperative or postoperative complications.The diameter of the dominant myoma varied from 10 cm to 15 cm.The operative time was(88±11) min.The blood loss was(743±251) m1.The first deflation began at(1.5±0.5) d after operation.The hysteromyoma weight was(320±80) g.All patients were discharged 3 d after operation.Conclusion Gasless laparoscopic myomectomy is feasible and safe for enormous hysteromyomas.Therefore it can represent an excellent option for the minimally invasive removal of enormous hysteromyomas.However,the blood loss should be worth attention.