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目的探讨腹腔镜辅助腹壁切口子宫壁间肌瘤剔除术的临床应用价值。方法将威海市妇女儿童医院妇科2006年1月～2009年12月需行子宫壁间肌瘤剔除术的患者267例分为三组,其中42例行AM术、96例行LM术、129例行LAM术。观察三组患者的手术时间、术中出血量、剔除肌瘤数量、肌瘤大小、术后恢复情况包括术后排气、术后镇痛、术后病率、住院时间及术后复发等。结果 LM及LAM组术中出血量、术后病率、术后镇痛、排气时间及住院时间等均明显优于AM组(P<0.05)。但剔除肌瘤数量、肌瘤大小、手术时间及术后复发率,LAM及AM组均明显优于LM组(P<0.05)。结论 LAM术既保留了LM的所有优点,又使子宫重建达到AM的手术标准,操作简单、安全易掌握,值得在临床上推广应用。
Objective To investigate the clinical value of laparoscopic-assisted excision of abdominal intrauterine myomectomy. Methods A total of 267 patients who undergone uterine myomectomy from January 2006 to December 2009 were divided into three groups. Among them, 42 patients underwent AM surgery, 96 patients underwent LM operation and 129 patients underwent LM operation Line LAM surgery. The operation time, intraoperative blood loss, the number of fibroids, fibroids size and postoperative recovery including postoperative exhaust, postoperative analgesia, postoperative morbidity, length of hospital stay and postoperative recurrence were observed. Results The blood loss, postoperative morbidity, postoperative analgesia, exhaust time and hospital stay in LM and LAM groups were significantly better than those in AM group (P <0.05). However, excluding the number of fibroids, fibroids size, operation time and postoperative recurrence rate, LAM and AM groups were significantly better than the LM group (P <0.05). Conclusion The LAM technique not only retains all the advantages of LM, but also makes the reconstruction of uterus reach the standard of AM surgery. It is easy to operate, safe and easy to grasp, and it is worth to be popularized clinically.