妇科腹腔镜手术中转开腹原因分析

目的探讨妇科腹腔镜手术中转开腹的相关危险因素。方法回顾性分析近3年778例接受妇科腹腔镜手术的患者中15例中转开腹的原因。结果中转开腹率为1.93%。主要原因为术中与术前诊断不符2例(13.4%);盆腔黏连3例(20.0%);术中并发症即出血而中转开腹3例(20.0%);因子宫肌瘤手术中转开腹3例(20.0%);输卵管间质部妊娠2例(13.3%);恶性肿瘤2例(13.3%)。结论盆腔黏连、并发出血、子宫肌瘤部位特殊等为妇科腹腔镜中转开腹最常见的原因。审慎选择病例,提高术前诊断率可以降低中转开腹率。适时中转开腹可以减少手术并发症及不良后果的发生。

Clinical analysis for conversion from gynecological laparoscopic surgery to laparotomy

Objective To study the related factors in conversion from gynecological laparoscopy to laparotomy.Methods A retrospective study were analyzed.15 out of 778 gynecology patients that were performed laparoscopic surgery in recent 3 years.ResultsFifteen cases were converted to laparotomy (1.93%).Causes of conversion were different between preoperative and postoperative diagnosis (13.4%),pelvic adhesion (20.0%),hemorrhage (20.0%),myoma of uterus (20.0%),ovarian malignant tumors (13.3%) and ectopic pregnancy (13.3%).Conclusion Pelvic adhesion,hemorrhage and peculiar location of uterine leiomyoma are the main causes of conversion from gynecological laparoscopy to laparostomy.Careful evaluation before surgery is important to reduce the rate of conversion to laparostomy.Converting from laparoscopy to laparostomy at the right time.