Early Outcome of Myomectomy with Laparotomy and Laparoscopy_West China Medical Journal

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Department of Obstetrics and Gynecology, People′s Hospital of Dujiangyan City, Chengdu, Sichuan 611830, P.R.China;

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Keywords：

子宫肌瘤; 子宫肌瘤切除术; 腹腔镜术; 剖腹术

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【摘要】目的 比较腹腔镜和开腹子宫肌瘤切除术在术后第1周的临床效果。方法将2008年1月-2009年12月收治的34例子宫肌瘤患者随机分为腹腔镜组17例，开腹组17例。所有患者均为肌壁间肌瘤或浆膜下肌瘤，肌瘤直径在5~15 cm之间且数目≤3个。结果两组患者手术时间相近；腹腔镜组术后体温恢复正常时间、肛门排气时间、排尿时间均短于开腹组（P lt;0.05）；腹腔镜组、开腹组术后血红蛋白下降更为明显（P lt;0.05）；术后7 d，开腹组腹痛视觉模拟评分明显高于腹腔镜组（P lt;0.05）。结论腹腔镜下子宫肌瘤切除术具有创伤小、恢复快、疼痛轻等优点,是一种安全有效的手术方法。
【Abstract】 Objective To compare the outcome of myomectomy performed by laparotomy and laparoscopy in the first 7 days after surgery. Methods Thirty-four patients with myoma less than three and in diameter of 5-15 cm from January 2008 to December 2009 were randomly divided into laparotomy group and laparoscopy group. Results Operation lengths were similar in the two groups. Time of paralytic ileus (P lt;0.05) and discharge (P lt;0.05) were longer in laparotomy group than laparoscopy group. Compared with laparoscopy group, laparotomy group had a greater hemoglobin decline (P lt;0.05). Time of post-operation fever were longer in laparotomy group than laparoscopy group (P lt;0.05). Seven days after surgery, the visual analogue scores of abdominal pain were higher in laparotomy group than in laparoscopy group (P lt;0.05). Conclusion Compared with the laparotomy myomectomy, laparoscopy myomectomy have mini trauma, quicker post operative recovery, and less pain. This method is safe and effective.

Citation： HE Hengjun. Early Outcome of Myomectomy with Laparotomy and Laparoscopy. West China Medical Journal, 2010, 25(9): 1646-1648. doi: Copy

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1. Miller CE. Myomectomy. Comparison of open and laparoscopic techniques[J]. Obstet Gynecol Clin North Am, 2000, 27(2): 407-420.
2. Dubuisson JB, Fauconnier A, Fourchotte V, et al. Laparoscopic myomectomy: predicting the risk of conversion to an open procedure[J]. Hum Reprod, 2001, 16(8): 1726-1731.
3. Falcone T, Bedaiwy MA. Minimally invasive management of uterine fibroids[J]. Curr Opin Obstet Gynecol, 2002, 14(4): 401-407.
4. 刘新民. 妇产科手术学[M]. 3版. 北京: 人民卫生出版社, 2003: 2403-2410.
5. 齐祥意. 子宫肌瘤患者不同术式临床诊治分析[J]. 中外医疗, 2010, (8): 19-20.
6. 张爱荣, 孔北华, 张萍. 腹腔镜下子宫肌瘤剔除术40例临床分析[J]. 实用妇产科杂志, 2005, 21(8): 497.
7. Seracchioli R, Rossi S, Govoni F, et al. Fertility and obstetric outcome after laparoscopic myomectomy of large myomata: a randomized comparison with abdominal myomectomy[J]. Hum Reprod, 2000, 15(12): 2663-2668.
8. Marret H, Perrotin F, Bougnoux P, et al. Low body mass index is an independent predictive factor of local recurrence after conservative treatment for breast cancer[J]. Breast Cancer Res Treat, 2001, 66(1): 17-23.
9. 边爱平, 赵倩, 周华. 腹腔镜子宫肌瘤切除术临床效果评估[J]. 中国实用妇科与产科杂志, 2008, 24(1): 65-66.
10. 张庆霞, 朱兰, 刘珠凤, 等. 开腹与微创子宫肌瘤切除术临床结局分析[J]. 中国实用妇科与产科杂志, 2008, 24(4): 278-281.
11. 白文佩, 穆兰芳, 周应芳, 等. 腹腔镜下和经腹子宫肌瘤切除术的临床比较[J]. 中国内镜杂志, 2007, 13(9): 903-905.
12. 吕品. 子宫肌瘤患者各种手术方式临床治疗分析[J]. 中国实用医药, 2010, (14): 29-30.

West China Medical Journal

Early Outcome of Myomectomy with Laparotomy and Laparoscopy

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