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腹腔镜下子宫动脉阻断联合优势肌瘤剔除治疗多发性子宫肌瘤98例 预览 被引量:16

Laparoscopic Uterine Artery Occlusion Combined with Ascendant Myomectomy for Multiple Uterine Myomas
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摘要 目的评价腹腔镜下子宫动脉阻断联合优势肌瘤剔除(1aparoscopic uterine artery occlusion combined with ascendant myomectomy,LUAO—M)治疗多发性子宫肌瘤的中期疗效。方法在腹腔镜下分离解剖子宫动脉主干,双极电凝或PK刀闭合子宫动脉,然后电针切开肌瘤表面包膜,使用剥离器剥离、剔除优势肌瘤(所有浆膜下肌瘤和径线≥3cm的肌壁间肌瘤),合成线单层连续缝合子宫表面浆肌层切口。结果手术时间(102±36)min;术中出血量(88.7±58.4)ml;术后住院(7.9±0.2)d;术后病率5.1%(5/98)。术后发生肠梗阻1例,皮下气肿2例,无其他严重并发症发生。98例随访21—52个月,平均36.3月,平均随访3.6次,月经异常缓解率95.9%(4/98),子宫体积平均缩小57.7%,肌瘤复发率3.1%(3/98)。结论LUAO-M治疗多发性子宫肌瘤具有良好的临床效果及中期疗效。 Objective To evaluate the middle-term effect of laparoscopic uterine artery occlusion combined with ascendant myomectomy (LUAO-M) for multiple uterine myomas. Methods The uterine artery was isolated and occluded with Kleppinger bipolar forceps (Sabre 2400, ASPEN LABS USA) or PK forceps (Gyrus Medical Limited Inc UK) under a laparoseope. Then dissection was performed on the surface of pseudo capsule with Kleppinger unipolar needle (Sabre 2400, ASPEN LABS USA) or PK needle (Gyrus Medical Limited Ine UK) , and the target myoma was stripped out of the tumor bed with the Separate-Scoop device. Afterwards, repair of the incision was carried out in one layer with interrupted single stitch by Absorbable VICRYL suture ( Johnson VICRYL ETHICON USA). Results The mean operation time was (102 ± 36) rain and mean blood loss was (88.7 ± 58.4) ml. The mean hospital stay after the operation was (7.9 ± 0.2) d, and febrile morbidity was 5.1% (5/98). Complications included two cases of subcutaneous emphysema and one case of ileus; no other severe complications occurred. Of the patients, 98 cases were followed-up for 21 to 52 months (mean, 36.3 months), during the period they were visited by a mean of 3.6 times, which showed a correction rate of menstruation abnormality of 95.9% (4/98) , rate of uterine volume reduction of 57.7% , and rate of recurrent myoma of 3.1% (3/98). Conclusion LUAO-M shows a good clinical outcome and middle-term effect for multiple uterine myomas.
作者 杨伟红 程忠平 戴虹 胡莉萍 罗莹莹 Yang Weihong, Cheng Zhongping, Dai Hong, et al. (Department of Gynecology, Yangpu Central Hospital, Shanghai 200090, China)
出处 《中国微创外科杂志》 2009年第10期 884-886,共3页 Chinese Journal of Minimally Invasive Surgery
关键词 腹腔镜 子宫动脉阻断 多发性子宫肌瘤 子宫肌瘤剔除术 Laparoscopy Uterine artery occlusion Multiple uterine myomas Myomectomy
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