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腹腔镜下子宫腺肌瘤切除术

Laparoscopic excision of uterine adenomyomas.

作者信息

Grimbizis Grigoris F, Mikos Themistoklis, Zepiridis Leonidas, Theodoridis Theodoros, Miliaras Dimosthenis, Tarlatzis Basil C, Bontis John N

机构信息

First Department of Obstetrics and Gynecology, Medical Faculty, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.

出版信息

Fertil Steril. 2008 Apr;89(4):953-61. doi: 10.1016/j.fertnstert.2007.04.063. Epub 2007 Jul 5.

Abstract

OBJECTIVE

To present a series of six consecutive women with adenomyomas who were successfully managed with a standard treatment strategy to elucidate the feasibility and the effectiveness of laparoscopic treatment of adenomyomas.

DESIGN

Cross-sectional case series.

SETTING(S): Obstetrics and gynecology department of a tertiary academic hospital and endoscopic unit of a private hospital.

PATIENT(S): The six cases described in this report were nonpregnant women of reproductive age (mean age, 34.8 years old; range, 29-38 years) who presented in the outpatient gynecological clinic for yearly routine visit (one patient), dysmenorrhea and menorrhagia (three patients), and history of pregnancy loss (two patients).

INTERVENTION(S): Laparoscopic excision of uterine adenomyomas.

MAIN OUTCOME MEASURE(S): Feasibility and effectiveness of laparoscopic management of adenomyomas.

RESULT(S): The average operating time was 100.5 minutes, and the average estimated blood loss was 163 mL. No event complicated the intraoperative and the postoperative course of these cases, and no case was converted to laparotomy. The mean follow-up was 13.7 months, with complete regression of the symptoms.

CONCLUSION(S): Excision of adenomyomas presents intraoperative peculiarities involving difficulties in their dissection and manipulation. Laparoscopic management of these lesions appears to be safe and feasible with good follow-up results and limited recurrence rates.

摘要

目的

报告连续6例子宫腺肌瘤患者采用标准治疗策略成功治疗的病例,以阐明腹腔镜治疗子宫腺肌瘤的可行性和有效性。

设计

横断面病例系列。

地点

一家三级学术医院的妇产科和一家私立医院的内镜科。

患者

本报告中描述的6例患者为育龄非妊娠女性(平均年龄34.8岁;范围29 - 38岁),她们因年度常规门诊就诊(1例)、痛经和月经过多(3例)以及流产史(2例)而到妇科门诊就诊。

干预措施

腹腔镜下切除子宫腺肌瘤。

主要观察指标

腹腔镜治疗子宫腺肌瘤的可行性和有效性。

结果

平均手术时间为100.5分钟,平均估计失血量为163毫升。这些病例的术中及术后过程均未出现并发症,也没有病例转为开腹手术。平均随访13.7个月,症状完全消退。

结论

子宫腺肌瘤切除术中存在一些特殊情况,包括剥离和操作困难。腹腔镜治疗这些病变似乎是安全可行的,随访结果良好,复发率有限。

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