Wei Feng-hua, Zhao Xiao-dong, Zhang Yi
Department of Obstetrics and Gynecology, Beijing Hospital, Beijing 100730, China.
Chin Med J (Engl). 2006 Nov 5;119(21):1790-3.
Vaginal myomectomy was firstly reported in 1994, however, it is a relatively new technique in China. The feasibility and safety of the procedure is still controversial in this country. The aim of this study was to analyze the outcomes of vaginal myomectomy in 90 patients and to investigate the feasibility and safety of the surgery.
From June 2001 to June 2004, 90 patients with uterine leiomyoma were treated with vaginal myomectomy in our hospital (vaginal group). The indications, operative performance, postoperative complications, and recovery of the patients were analyzed and compared with those of 93 patients with uterine leiomyoma treated by laparotomic myomectomy from January 2000 to January 2001 (laparotomy group). The Student's t test was used to compare the continuous variables between the two groups, and the chi-square test was used to compare the categorical variables. The vaginal and laparotomy groups were followed up for 10 - 34 months (median, 21) and 15 - 24 months (median, 30), respectively.
Vaginal myomectomy was performed successfully in 87 of the 90 patients (96.7%). In the other 3 patients, the procedure failed and laparotomy was carried out. In both groups, the uterus was enlarged to 8 - 16 weeks gestational size (median, 10 gestational weeks). The number of resected tumors was 1 - 12 (median, 2) in the vaginal group and 1 - 15 (median, 4) in the laparotomy group, respectively (P > 0.05). The mean operating time, intraoperative blood loss, and postoperative hospital stay were (52 +/- 21) minutes, (230 +/- 44) ml, and (7.0 +/- 1.2) days in the vaginal group, and (65 +/- 32) minutes, (200 +/- 56) ml, and (7.0 +/- 1.5) days in the laparotomy group (P > 0.05). The mean top postoperative temperature was (38.4 +/- 1.1) degrees C and (37.8 +/- 0.6) degrees C in the two groups respectively (P < 0.05). Both groups had one recurrent case during the follow-up (P > 0.05).
Vaginal myomectomy is feasible and safe in treating uterine leiomyoma. To some extent, it is superior to laparotomic myomectomy by avoiding severe trauma during the surgery.
阴道肌瘤切除术于1994年首次报道，然而，在中国它是一项相对较新的技术。该手术的可行性和安全性在我国仍存在争议。本研究的目的是分析90例患者行阴道肌瘤切除术的结果，并探讨该手术的可行性和安全性。
2001年6月至2004年6月，我院对90例子宫肌瘤患者行阴道肌瘤切除术（阴道组）。分析患者的手术指征、手术操作、术后并发症及恢复情况，并与2000年1月至2001年1月行开腹肌瘤切除术的93例子宫肌瘤患者（开腹组）进行比较。采用Student's t检验比较两组的连续变量，采用卡方检验比较分类变量。阴道组和开腹组分别随访10 - 34个月（中位数，21个月）和15 - 24个月（中位数，3个月）。
90例患者中87例（96.7%）成功行阴道肌瘤切除术。另外3例手术失败，改行开腹手术。两组患者子宫均增大至妊娠8 - 16周大小（中位数，10孕周）。阴道组切除肌瘤数量为1 - 12个（中位数，2个），开腹组为1 - 15个（中位数，4个）（P>0.05）。阴道组平均手术时间、术中出血量及术后住院时间分别为（52±21）分钟、（230±44）ml和（7.0±1.2）天，开腹组分别为（65±32）分钟、（200±56）ml和（7.0±1.5）天（P>0.05）。两组术后最高体温平均值分别为（38.4±℃）和（37.8±0.6）℃（P<0.05）。随访期间两组均有1例复发（P>0.05）。
阴道肌瘤切除术治疗子宫肌瘤可行且安全。在一定程度上，它优于开腹肌瘤切除术，可避免手术中的严重创伤。
