摘要
目的:探讨悬吊式腹腔镜子宫肌瘤切除术的可行性。方法:2007年10月至2012年5月为228例患者行腹壁悬吊式腹腔镜子宫肌瘤切除术,并分析手术情况及术后恢复情况。结果:221例患者顺利完成手术,4例因盆腔粘连严重、2例因子宫如孕80余天、1例因合并侧腹膜巨大脂肪瘤中转开腹。手术时间40～150 min,平均(80±20)min;出血量5～300 ml,平均(100±40)ml。挖出肌瘤1～21枚,包括子宫前壁、后壁、宫底、宫角、宫颈及阔韧带肌瘤,均为肌壁间或浆膜下肌瘤。术后当日晚或次日排气,无皮下气肿、切口感染、化学性腹膜炎等并发症发生;术后3～7 d出院。结论:悬吊式腹腔镜子宫肌瘤切除术是腹腔镜手术与开腹手术的完美结合,并不能完全替代气腹腹腔镜手术及开腹手术,为减少并发症的发生,应适当选择病例。
Objective：To investigate the feasibility of suspended laparoscopic hysteromyomectomy. Methods：Suspended lapa- roscopic hysteromyomectomy was performed on 228 patients from Oct. 2007 to May 2012 ,and the intraoperative details and postoperative recovery were analyzed. Results： Laparoscopic surgery was performed successfully on 221 patients, conversion to open surgeries were conducted in 4 patients with tense pelvic adhesion,2 patients whose uteri were as large as 80 days pregnancy and 1 patient complicat- ed with huge lipoma in the side peritoneum. The operation duration was 40-150 min, mean （80 -＋ 20） min;The intraoperative blood loss was 5-300 ml,mean （100 ~40） ml;The number of myoma resected in one operation was between l and 21 and the myoma were either intramural or subserous which located at anterior wall, posterior wall, fundus, corner, cervix or broad ligament of uterus. Intestinal func- tion recovered in the night of surgery or on the next day of operation. No subcutaneous, emphysema, incision infection, chemical peritoni- tis or other complications occurred. The hospital stay was 3-7 d. Conclusions：Suspended laparoscopic hysteromy0mectomy is the perfect combination of laparoscopy and laparotomy, but it can not completely replace the two. Proper selection of patients is the key point to re- duce complication incidence.
出处
《腹腔镜外科杂志》
2013年第3期229-231,共3页
Journal of Laparoscopic Surgery
