腹腔镜下子宫肌瘤剔除术的临床观察
【摘要】 目的：探讨腹腔镜下子宫肌瘤剔除术的手术适应证、禁忌证、手术方法，术后并发症及效果。方法：腹腔镜下子宫肌瘤剔除术２２例，肌瘤直径１５～７cm。结果：共剔除肌瘤２５个。多发２例，合并卵巢瘤２例，合并宫外孕３例，单发１５例。镜下缝合１７例，未缝合５例。手术时间、出血量与肌瘤的大小成正比。结论：带蒂浆膜下肌瘤、单发壁间肌瘤直径小于７cm，于腹腔镜下行子宫肌瘤剔除术效果好。
Clinical observation of laparoscopic myomectomy。
【Abstract】Ｏbjective:To study the indications,contraindications, surgical methods and complications of laparoscopic myomectomy(LM).Methods:A retrospective study was carried out to 22 patients who received laparoscopic myomectomy.Results:A total of 25 UMs were removed from these patients,which included single UM in 15 cases, coexisting ovarian tumors in 2 cases and extrauterine pregnancys in 3 cases. In 17 cases the uterine wall was sutured in under laparoscopy. Operative time and blood loss were in direct proportion to the size of the tumors.Conclusions:This study suggests the feasibility of laparoscopic myomectomy in subserous UMs and intramural UMs whose diameter are less than 7cm.
【Key words】Laparoscopy;Uterine myoma; Myomectomy。
通过我院腹腔镜下子宫肌瘤剔除术２２例临床观察，探讨腹腔镜下子宫肌瘤剔除术的手术适应证、禁忌证、手术方法、术后并发症及效果。
1 资料与方法。
1１临床资料。
2002年1月至2004年7月我院于腹腔镜下行子宫肌瘤剔除术22例，肌瘤直径1.5～7cm，24～43岁，孕产次０～5次。已生育14例，未生育8例。月经周期缩短10例，腹部不适、尿频7例，5例无症状于体检或因其他疾病手术时发现。术前壁间肌瘤、浆膜下肌瘤诊断无误。行腹腔镜下子宫肌瘤剔除术。
１2 手术步骤。
手术行硬膜外麻醉，下腹部四点穿刺。带蒂浆膜下肌瘤，双极电凝瘤蒂，剪断。壁间突向浆膜的肌瘤，先于肌瘤表面切口周围注射催产素，然后单极电钩切开子宫浆膜层、子宫肌层到瘤体，分离包膜，剔除肌瘤，2０可吸收线８字缝合瘤腔。小肌瘤，位置表浅，双极电凝止血，不缝合。组织粉碎器将肌瘤粉碎成条状取出。